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Please list each course you are applying for with course number and name.
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Student Information
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Must be 9 characters. Currently Entered: 3 characters.
You unique Concordia University issued student identification number.
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Alumni Information
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Employer Information
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If you believe your company should be listed, please call us.
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How did you hear about this scholarship opportunity? *
Check all that apply
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Signature *
I understand that checking the Signature box constitutes a legal signature confirming the truthfulness of the information provided in this application.
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