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900 West Orman Ave.
MT-118
Pueblo, CO 81004 |
Phone Fax: 719-549-3463
Fax: 719-549-3464
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Past Participant Survey: This information is essential to ensure our continued funding for future participants. Your response by January 15th of each year is greatly appreciated.
Please answer the following questions. Mail or Fax to PCC Upward Bound Office above
| First and Last Name |
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Maiden Name |
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Mailing info |
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Hm/wk phone numbers |
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E-mail Address |
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What are you doing now? ( working, going to college, work and college, military, other) |
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Are you now or have you attended College? |
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If yes, Name of College? |
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State the college is in? |
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Full or part time? |
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Grade level? |
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Major? |
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Where was the first College you enrolled in? |
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State the College is in? |
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Date you enrolled? |
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Have you earned a degree? |
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Name of your degree? and major? |
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Date you received degree? |
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College you received degree from? |
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Year you entered PCC UB?
High School and Class of? |
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Please list any comments about how Upward Bound was beneficial to you on the back. |