PX-Grocery Pickup -Account Set-up 
Please complete the following information below.  Once you have completed this the first time you will no longer be required to complete.  
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First Name *
Last Name *
Age  *
Campus Mailbox # or address of off campus living  *
City, State, Zip  *
Email  *
Phone -Will only contact if there is a question about your order.  *
Income-Weekly (non work-study) 
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