2024 - 2025 Trilogy Information Form

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Please complete each box as accurately as possible.

First Name *

Last Name *

My Cell Phone Number *

type NONE if you don't have a cell phone

Would you like to find out how to get REMIND messages on your email? *

type NONE if you don't have a cell phone

Yes please.

No thank you.

My best contact E-Mail address *

Birthdate *

YYYY

Year in School (Next Year) *

Part Assigned *

Is your home address the same as your mailing address? *

Home Address *

Street

City *

Zip *

Home Phone (or type NONE) *

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