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| hope college > student development > multicultural education |
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Inactive Membership Form
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| Name: | _________________________________________ |
| Campus Address: | _________________________________________ _________________________________________ |
| Campus Telephone: | _________________________________________ |
| School Year: | _________________________________________ |
| Major(s): | _________________________________________ |
| Reason for eligibility: | _________________________________________ _________________________________________ _________________________________________ _________________________________________ _________________________________________ |
________________ Your Signature & Date |
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________________ Executive Board Approval Signature & Date |