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Extra-curricular Survey Required For All Participants Active June 1, 2015-May 31, 2016
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Student Name
*
First
Last
Did you work at least 10 hr/wk at any point from 6/1/14-5/30/15?
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Yes
No
Number of hours worked weekly
*
Did you do any community service between 6/1/14-5/30/15
*
Yes
No
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