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Name of Student
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First Name
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Last Name
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Name of Parent/Guardian
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First Name
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Last Name
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Name of Teacher/Counselor/School Administrator
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First Name
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Last Name
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Name
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First Name
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Last Name
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Address
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Address Line 1
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Student's current high school grade level
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10th
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How did you hear about us?
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Field student is interested in studying
Political Science, Pedagogy/Teaching, History, Film, Mathematics, Engineering, etc.
What aspect of the Texas Academy are you most interested to learn about?
Housing/Residence Life, Student Engagement, Academics, Activities, Research & Scholarship
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