Community Health Initiative (CHI) Consulting Project Application (Student Form)
FOR MORE INFORMATION, PLEASE GO TO THE CHI WEBSITE: https://diversity.umn.edu/bced/node/75
Full Name (First and Last) *
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Street Address (Including Apt or Unit #) *
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City *
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State *
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Zip Code *
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Cell Phone *
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E-mail (UofM E-mail ONLY) *
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Student ID Number (7-digits) *
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Anticipated Graduation Date (Month/Year) *
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Degree *
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Major area(s) of study *
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