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Get Amica Good Student Discount Form

Enrolled as a full-time student and has attained the rank of: Freshman Sophomore Junior Senior* Other (explain) High School Name and Address College or University Name and Address *If a senior, will student continue to attend school full time after graduation? Yes No The scholastic records for the immediately preceding semester (or comparable period) show that the above named student has attained one or more of the following: Ranked in the upper 20 percent of the class scholastically; or.

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