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Lead
Entry Form - EVENT
First Name *
Last Name *
Email *
Phone *
Campus *
Select One
AUS
BROWN
CC1
HAR
PHAR
SAN1
SAN2
WAC
Program of Interest *
Select One
Administrative Assistant
Auto Apprenticeship
Business Accounting Specialist
Business Administration
Computer Support Specialist
Cosmetology Operator
CMVO
Electrical Technician
Esthetician
HVAC
Medical Assistant
Medical Billing & Coding Specialist
Medical Office Specialist
Nurse Aide
Pharmacy Technician
Welding
Rep ID
Event Type *
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Classroom Presentation
College Fair
General Event
Event Code *
Current High School Student *
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Yes
No
High School Expected Graduation Year
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