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Questionnaire

Name

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Email

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Phone Number

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Mailing Address (Address, City, State, Zip Code)

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Are you a rising junior or senior student?

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Are you enrolled in an accredited Ohio College or University?

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Which College or University are you enrolled in?

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What is you major?

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What makes you an ideal candidate to receive the Hrobuchak Scholarship?

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Why did you choose your major or course of study, and what would receiving a scholarship mean to you?

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What is you cumulative GPA?

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