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Get & Engagement - Ut

R Application 2010-2011 Name: Campus Box #: Phone #: Email Address: Student ID #: Cumulative GPA: Fall 2009 GPA: Are you eligible for federal work-study? yes no By signing below, I authorize the Office of Student Leadership and Engagement staff to access my judicial/disciplinary file and academic records to confirm my eligibility for a position. Signature: Date: After reviewing the student coordinator job descriptions on the following pages, please rank in order your top two.

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