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Work Entry
Campus
Rockford (Spring Creek)
Cape Coral
Janesville
Campus is required.
First Name
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First Name is required.
Last Name
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Last Name cannot contain emojis or special fonts.
Last Name is required.
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Birthdate
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Birthdate cannot be a future date.
Gender
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Female
Gender is required.
Date Planning To Attend
Date Planning To Attend is required.
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