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Dubois Nubian Junior Research Fellowship Program
Student First Name
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Student Last Name
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Parent / Legal Guardian # 1
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Last Name
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Phone
Parent / Legal Guardian # 2
First Name
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Last Name
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Will you make your own way home?
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Why are you interested in this position?
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List Extra-curricular activities:
List the 3 most important academic classes you took in your recent academc year:
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Proof of Residence
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Proof of Age
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Proof of School Enrolment
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Resume & Cover letter
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