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Alumni/Community Member Intake Form
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
*
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone Number
Graduation Year (If applicable)
From a Minnesota based institution
University Name
University of Minnesota
University of Minnesota-Duluth
St. Thomas University
St. Cloud State University
Carleton College
Augsburg College
Other