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Get Nursing Scholarships Application Form

First Name: Last Name: UTEID: Address: City: State: Phone: Citizenship: Zip: County: E-mail: US: Permanent Resident: Yes Did you attend High School in Travis County: Yes Other: Are you a TX resident? Yes Are you an International Student? Yes If you have a particular clinical area of interest, please indicate: Undecided Semester & year for which you are applying: Fall 2012 and Spring 2013 Anticipated credit hours of enrollment: Fall 2012 Spring 2013 Expected date of grad.

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