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Student's First Name

Student's Middle Name

Student's Last Name

Student's Email Address

Student's Birthdate

Gender:

Female

Male

Citizenship

In which year do you expect to enroll at a college or university?

What is the name of your high school?

In which city is your high school located? (e.g. Wellington)

In which country is your high school located?

How many friends or family members do you plan to bring with you?