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Student First Name: Student Last Name: Email: Phone: Address: Birth Date: / / Gender: Female Male High School Name High school type Anticipated graduation year How did you hear about Gutenberg College? Print publications Social media Internet or website Gutenberg-sponsored event or class College fair Word of mouth or referral Other I'd like emails about Gutenberg's scholarships and events for high school students: Additional Information: Emergency Contact: First Name Emergency Contact: Last Name Emergency Contact: Phone Emergency Contact: Phone Type Mobile Home Work Emergency Contact: Relation If you have a coupon, please enter code here (case-sensitive):