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Date:
Name (First, Last)
Pemanent Address:
Phone:
E-mail:
Date and Place of Birth:
What is your Ethnicity?
White Non-Hispanic
Latino/a/e
Black
Asian/Pacific Islander
Native American/Indigenous
Middle Eastern
Other
Are you a First-Generation College Student?
Yes
No
How did you hear about Cumbres?
Counselor/Teacher
Presentation or Communication from UNC
Other (please explain)
High School Attended, GPA, SAT/ACT Score:
Anticipated Major at UNC:
Please provide a short biography of yourself:
Why are you interested in becoming a teacher?
What are your future goals as a public school teacher?
What strengths and qualities will you bring to the field of education?
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