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Eligibility Affidavit Form
Number(s): ________________________________
Email Address: ________________________________
Personal Information:
Home Address: ___________________________
______________________________________
Street Address
City, State, Zip Code
Phone Number: ________________________________
Parents’ Names: ________________________________
Are you a United States Citizen or a Permanent Resident*?
Yes _____ No _____
Are you on another type of VISA?
(*Holder of a Green Card or F1 VISA)
Yes _____ No...
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