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Secondary Address

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Gender*
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Birthdate*

99/99/1999
NSHE ID
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I.D. Type
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Social Security Number or Individual Taxpayer Identification Number (ITIN)

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Employment Status*
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If you are seeking employment, in what area?*

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Highest Education Level*
Where did you study?

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Native Language
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GED/HSE/HiSET Area(s) You have Passed

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Would you like a CSN admissions counselor to contact you about continuing your college education?
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Type of computer you have at home

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Race*
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