Community & Contact Details

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Organization Name
First Name
Last Name
Title
Email  (please use your institutional email for verification)
Telephone  (xxx-xxx-xxxx)
Fax  (xxx-xxx-xxxx)
The CLIC currently is registering community-based and scholarship organizations that meet at least one of the following (please check all that apply):
501(c)
Government Agency or Program
Secondary School-affiliated
College/University-affiliated
Please Choose College
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