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Get Utah's Statewide Gear Up Education Program Application

Hool/District ID #: Address: City: Yes Social Security #: Zip: Grade: Age: Gender: Birthdate: Parent/Guardian Name(s): Parent/Guardian Relationship(s): Parent/Guardian Home Phone: Parent/Guardian Work Phone: Parent/Guardian Cell Phone: Student Cell Phone: Parent/Guardian E-mail: Student E-mail: What is your preferred Language? How many people currently live in your home? Do you have any other siblings in high school? Yes No Schoo.

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