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name
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Phone Number xxx-xxx-xxxx *
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University Name
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School Email
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Anticipated Graduation Date
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Are you a college athlete?
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Which sport(s)
Are you in a Fraternity/Sorority?
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Which Fraternity/Sorority
Which product would you like to represent?
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Why do you think you'd be a great ambassador?
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What is your favorite flavor of drink and why?
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