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name:

e-mail:

First Name:
Last Name:
Gender:	MaleFemale
Address:
Address (Line 2):
I plan to enter Concordia as a:	FreshmanTransfer
City:
State:
ZIP:
Country:
Phone:	() -Second partThird part
E-mail Address:
Possible Major(s):
Extracurricular Interests:
GPA:
ACT/SAT Score:
Semester I plan to enroll:	FallSpring
Year of College Entrance:	201120122013
Questions or Comments::