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College/University:
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Name of School if not listed
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Fraternity/Sorority/Group:
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First name:
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Last name:
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Cell/Main Phone number:
(xxx-xxx-xxxx)
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Email:
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Graduation year:
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Other colleges you have references for Reps:
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Position applying for:
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Which Trip you are interested in promoting?
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| Reasons why we should choose you: |
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List activities (positions/chairs held, intramurals, jobs, etc.):
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Estimated number of travelers:
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