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Name
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First Name
Last Name
Email
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example@example.com
Please select the option that best describes you:
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I am an undergraduate student interested in Network Fellowships
I am a college/university employee (both faculty and staff)
Your college/university that you currently attend
Please use the institution's full name (ex: New York University as opposed to NYU)
Which of the following best describes your academic status:
First-year
Sophomore
Junior
Senior
What is your expected graduation year?
2024
2025
2026
2027
Department Type that best defines the scope of your work with students
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Academic
Administrative
Multicultural
Your Title
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Your Department Name
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Your Higher-Ed Institution
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State where your institution is located
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Please Select
AL
AK
AR
AZ
CA
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CT
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DE
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HI
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KS
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NE
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OR
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