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Student Email
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Students First & Last Name
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Student Date of birth
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Guardian' s Phone #
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Guardian's Email
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Tell me about yourself? (100 words or less)
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Why are you interested in the program? (100 words or less)
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How do you feel this program will benefit you in the future?
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What are challenges do you anticipate during the program & how do you plan to deal with these challenges in order to complete the program?
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On a scale 1-3 How committed are you to finishing the task you start ?
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1
2
3
Any questions for us?
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