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Title
First Name
Middle Initial
Last Name
Name while attending FIU, if different
Birthdate
FIU Degree(s) & Major(s)
Graduation date(s)
Marital Status
Spouse / Partner's Name
(If person is an FIU graduate, please list name while attending FIU and year graduated)
Home information
Address
City
State
ZIP
Phone
E-mail address
..
Business information
Business Title
Business Name
Address
City
State
ZIP
Phone
FAX
E-mail address

Please list activities while at FIU (student government, fraternity, sorority, etc.)