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CURAC Membership Form: Personal Details
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First Name
*
Your answer
Last Name
*
Your answer
Date of Birth
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MM
/
DD
/
YYYY
Email address
*
Your answer
Telephone Number
*
Your answer
How are you associated with the university (or not)?
Undergrad student
Postgrad student
Staff
Alumni
Not associated
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College (if applicable)
Your answer
College Tutor (if applicable)
Your answer
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