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Thank you for your interest in Become a Teacher Day! Please fill out the form below to RSVP for Become a Teacher Day on April 20, 2017 at Purdue University.
Student's Name- First, Middle, Last
Student's Email address
Student's Home Address
Name of student's High School
Student's current Grade Level
Student's date of birth
Student's t-shirt size
Name of Parent/ Legal Guardian
Email address of Parent/ Legal guardian
Phone number of Parent/ Legal Guardian
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