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Recruit me for Augustana Water Polo

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Personal

Student first name *

Student last name *

Preferred first name (ONLY if different than first name)

Birthdate *

Student email address *

Parent email address

Citizenship status:

U.S. citizen

U.S. permanent resident

Non-U.S. citizen

Country of citizenship:

Intended Visa type:

Academic

Entrance status *

Anticipated enrollment term *

Current high school/institution*