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ZIP Code E-mail Address Date of Birth mm-dd-yyyy FOR STATISTICAL PURPOSES ONLY - Ethnic Origin choose one Race choose one or more regardless of Ethnicity 01 Hispanic Latino 02 Not Hispanic Latino 01 White 02 Black or African American 04 American Indian or Alaska Native 05 Asian 08 Native Hawaiian or Other Pacific Islander Gender choose one F Female M Male II. RECORD OF EDUCATION Documentation of graduation from high school or the completion of the equivalent of a high school program will be...
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