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Name of funding Organization Total amount of assistance for 2013-2014 Student signature Date Please return this form to Southern Methodist University Office of Financial Aid Blanton Student Services Bldg Suite 119 Fax 214-768-3997. I will not receive any off-campus financial assistance transportation or book allowance fellowship stipend or assistantship etc. from a church and/or conference between September 2013 and May 2014. Name please print SMU ID Phone Number Email Please indicate below...

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