New Applicant Scholarship Application

R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
D
DEADLINE
TO
T SUBMIT
T COMPLET
TED “NEW”” APPLICAN
NT APPLICA
ATION IS
MARC
CH 31 OF TH
HE APPLIC
CATION YEA
AR
Thank you for applyin
ng to our Reyy Feo Scholarrship program
m. We are loooking forwarrd to workingg with
each studeent that is aw
warded a schollarship duringg the upcominng years from
m our organizaation. “Comm
mittee
of LULA
AC Council No.
N 2” will reeview the schholarship appllications and will determiine the scholaarship
awardees by June 30. Everyone that submitted an applicatioon will be nottified by maill stating the results
r
of their appplication.
ELIGIB
BILTY REQ
QUIREMEN
NTS:
Applicannts must meet the following criteria to
t be consideered for a sccholarship:
•
•
•
•
•
•
•
•
High School Senior
H
S
pendingg graduation or
o no more thhan 12 months after graduaation.
M be a stud
Must
dent pursing full-time
fu
studiies leading to a bachelor’s degree at a coollege or
unniversity apprroved by Thee Rey Feo Schholarship Revview and Selection Commiittee.
For entering frreshman, musst have a gradde point average of at least 2.5 on a 4.0 scale
s
equivaleent.
For entering frreshman, musst have a scoree of at least 23 on the ACT
T (composite)) or at least a score
off 970 on the SAT
S
test (com
mbined verball and math) coonsidered as honor
h
studentts.
A a college sttudent, must maintain
As
m
a college grade pooint average of
o at least 3.000 on a 4.0 graade
sccale or equivaalent.
A applicants must be U.S. Citizens.
All
N over fundeed from total scholarships and grants aw
Not
warded.
L
Limited
only one
o Rey Feo Scholarship
S
p family perr year.
per
APPLIC
CATION PR
ROCESS: Appplicants muust completee and submitt the followinng:
FOR NE
EW APPLIC
CANTS:
•
•
•
•
•
•
•
Complete Secttions A througgh N.
C
Suubmit OFFIC
CIAL High Scchool Transcrript (with an authorized
a
siggnature, seal or
o stamp).
Suubmit a copy of ACT and//or SAT test scores
s
or recoorded on transscript.
Suubmit an acceeptance letterr of the collegge/university you
y plan to atttend in the faall, EXCEPT
coommunity college.
Inncome Tax Reeturns from thhe last 3 conssecutive yearss from both paarents and/or guardians.
T
Three
(3) Letteers of recomm
mendation froom adults addrressed to Thee Rey Feo Schholarship, Incc.
Innclude a comp
plete name, teelephone num
mber and mailling address for
f each refereence. (1) Teaccher
(11) Employer or
o Parent of Applicant
A
(1) Neighbor or Family
F
Friendd. Possible innquiry might be
b
neeeded for pro
ocessing schollarship appliccation.
A
Answer
all queestions to the best of your ability. Pleasse do NOT leave any questtions unanswered.
Inndicate Does Not
N Apply (DNA
A) or explain omission.
o
1
R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
TION CRIT
TERIA:
SELECT
•
•
•
•
•
Likelihood of pursing
L
p
a successful careerr in college.
A
Academic
perfformance, wriiting ability, especially
e
muulti-lingual.
E
Extracurricular
r activities, coommunity invvolvement annd recommenddations.
E
Effects
on the local commuunity by awardding you our scholarship.
H this schollarship educaational award will help youu, your familyy and this com
How
mmunity?
DISBUR
RSEMENT FUNDS:
F
Aw
warded monnies will be distributed
d
ass follows:
•
•
First half of Th
he Rey Feo Scholarship wiill be disburseed in the fall of
o the awardeed year to the
coollege/universsity we have on file (all chhanges must be
b submitted in
i writing andd in a timely
m
manner
to avoiid delay of paayment to the awardees schhool).
Second half off The Rey Feoo Scholarshipp will be disbuursed in the sppring of the awarded
a
year based
b
onn:
o After completion of
o the fall sem
mester, awardeees must subm
mit an OFFIC
CIAL transcrippt of
their fall
fa grades whhich reflect at least a cumullative grade point
p
3.0 or abbove on an
averag
ge of 3.0 on a 4.0 scale.
o Studen
nt must providde a class schhedule verifying full-time status
s
of at leaast 12 hours for
f
the sprring semesterr to receive thhe second disbbursement of The Rey Feo Scholarship.
DEFERM
MENTS: Applicants
A
whho submitted completed appplications thhat were acceppted and appproved
for awardd, but were no
ot able to acccept due to Military
M
service, immediatee family deathh, serious injuury or
sickness of
o applicant will
w be alloweed to defer aw
ward up to 122 months. Doocumentation for defermennt will
be requireed.
REY FEO SCHO
OLARSHIP
P PROGRAM
M
The Rey Feo Scholarrship Program
m is intendeed to assist and
a
encouragge students in
i completingg and
advancingg their colleg
ge education.. The progrram is directted specificallly to San Antonio
A
and Texas
T
Educationn Service Cen
nter Region 20
2 school disttrict students with career advancement
a
in mind. Thee Rey
Feo Schollarship, Inc., is a non-proffit corporationn of LULAC Council No. 2, an Originnal Charter Coouncil
and affiliaate member of the League of United Lattin Americann Citizens (LU
ULAC).
TERMS: The Rey Feeo Scholarshipp Program wiill award $1,5500.00 scholaarships to quaalified San Anntonio
area studeents who aree enrolled or are planningg to enroll leading to a foour-year or greater
g
degreee at a
college orr university approved
a
by The Rey Feo Scholarshipp Program. The $1,500.000 awards will
w be
divided innto two equall disbursemennts made by September 15 and Januarry 31. Scholaarships awardds are
sent direcctly to the reciipient’s collegge or university and depossited in the reecipient’s nam
me. The fundds will
be allocaated towards the paymentts of tuition, academic fees,
f
the purrchase of reqquired educaational
materials and books. The
T school iss custodian off the funds annd will be disbburse the awaard as directeed and
consistentt with the purrpose and pollicies of this program.
p
Item
ms outside thhe above listeed expenses are
a the
student’s responsibility
y.
2
R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
A
T’S PERSO
ONAL INFO
ORMATION
N
A. APPLICANT
Name:
Address:
City & State:
Email adddress:
Social Seccurity #:
Place of Birth:
B
Marital Sttatus:
Birtth Date:
Phoone:
Zip Code:
Celll Phone:
U.S. Citizen: Yess
Numbeer of dependannts:
No
A
Ages:
B. APPLICANT
A
T’S EDUCA
ATIONAL DATA
D
High Schoool Attended::
If not gradduated, will you
y graduate this
t spring?
GED Gradduate: Yes
Yeear Tested:
Other training (Vocatio
onal, Techniccal, and Clericcal):
Yes
Year Graaduated:
N
No
Test Scoores:
C. APPLICANT
A
T’S EMPLO
OYMENT DATA
D
Are you employed
e
now
w? If yes, pleaase list emplooyer below.
Your Empployer:
Wage:
p
per
Your Empployer:
Wage:
p
per
Will you be
b living at your parent’s home
h
while attending
a
colleege? If away from home, how
h
will you pay
p for it?
Will yourr family proviide financial support
s
to youu while attendding college? If no, how will
w
you suppoort yourself while
w
attending college fulll-time?
D. ACTIVITIE
A
S DATA
Please lisst all Civic or
o Club Mem
mbership andd School Acttivities, Incluude Communnity Services,
Church, Boy
B or Girl Scouts, and Etc. program
ms. Please atttach a separrate sheet if needed.
n
Are you a LULAC Youth
Y
Membber? Yes______
Sponsorrs
No______
3
C
Council
#
R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
E. CHARACT
C
ER REFER
RENCES
List threee personal ch
haracter refeerences:
Name of
o Reference
Occcupation
Phone Number
Relaationship
F. COLLEGE
C
OR UNIVE
ERSITY CH
HOICE:
List full name
n
and ad
ddress of colleege or univerrsity you willl be attendin
ng or plan to attend:
Name:
Address:
City:
State:
Z Code:
Zip
Have youu been accepteed to above innstitution? Yes
N
No
PLEA
ASE ATTAC
CH A COPY OF YOUR ACCEPTAN
A
CE LETTER
R.
G. FINANCIAL
F
L AID: Pleas
se list all otther grants or scholars
ships applie
ed for:
Name of Organization
Requiirements
Potential $ Amount
Awarded
Amount off Award
H. FAMILY
F
DA
ATA
Dual Pareent Same Hou
usehold: Yes
Number of
o family-depeendent childrren:
Father’s Name:
N
Address:
Living at Home:
Yes
Mother’s Full Name:
Address:
Living at Home:
Yes
No
Singgle Householdd: Yes ____ No
N
Ages of fam
mily dependennt children
Occcupation:
Employyer:
P
Phone:
No
Occcupation:
Employyer:
P
Phone:
No
List last three
t
combin
ned Annual Incomes of both
b
parentss from 1040 Tax Returnss:
This Yearr:
Laast Year:
Previouss Year:
Please atttach compleeted and signned copies off 1040 Tax Returns
R
4
R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
T BE FILL
LED OUT BY
B SCHOOL COUNSE
ELOR ONL
LY
I. TO
Check List:
L
Official High
H
School Transcript
T
A
Attached:
Yes ____ No__
___
Parent /G
Guardian 104
40’s Income
e Verification
n for the past three yearss: Yes___ No_____
N
School Recommenda
R
ations (Optio
onal) ______
__________
____
ACT Tesst: Date ____
__________
____ Locatio
on ________
_________ Score
S
_____
_______
SAT Tesst: Date ____
__________
____ Locatio
on ________
_________ Score
S
_____
_______
Please Complete:
C
High Sch
hool Rank __
_________ of
o ________
___ Class Sttudents
Six-Seme
ester Grade Point Avera
age _______
__________
______
High Sch
hool Attenda
ance, Absencces _______
____ in ____
_______ yea
ars
List Participation in School
S
Activiities (please
e attach a se
eparate shee
et of paper if needed:
Signed ___________
_
__________
__________
__ Title: ____
_________ Date:
D
_____
________
Verification Enclossures 1. O
Official High School
S
Transccript or copy of GED Tesst Scores with
h this applica
ation. If student is
grraduating from
m high schoo
ol this spring, an official le
etter or transcript from the
e school indiccating
yo
our grade point average. Due to the academic
a
req
quirements, applications
a
m
must
be either high
scchool graduattes having graduated no more
m
than 12 months past, high school seniors gradu
uating
th
his spring, or persons of compatible
c
ag
ge who have passed the GED
G
equivale
ency with high-test
sccores. You may also in
nclude any letters
l
of reccommendatio
on relevant to
o this schola
arship
ap
pplication.
2. Copies
C
of parrents’ Form 1040
1
tax retu
urns and applicable attacchments (W2
2’s, social se
ecurity
ve
erification, dis
sability verification, etc.) fo
or the last thrree years to show
s
proof off income.
Applications without
w
veriffication are considered
c
in
ncomplete
and
d will automatically be disqualified!
3. A listing of all other
o
scholarrships and gra
ants you have
e applied for, been awarde
ed or will exp
pect to
re
eceive toward
d your college
e education. List
L amounts of
o money and
d compensatio
ons provided.
4. Liist all other government
g
a private monetary assisstance you ha
and
ave applied for,
f
been awa
arded,
orr will receive toward yourr subsistence while attend
ding college. If you applied
d for a Pell Grant,
G
pllease include
e your index number. If you
y
have alre
eady received it and/or th
he annual am
mount
exxpected to be
e received.
5
R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
ory
Appllicant Reciipient Histo
J. Are
A you a preevious Rey Feo
F or other LULAC Schholarship Reecipient: Yess__ No__
Iff yes, please indicate last year
y awarded__________ annd previous aw
ward #______________
A
Award
Provid
ded by: ____________________________________
___________________
o
inform
mation you wish to state in this appliccation:
K. Provide any other
____________
____________________________________________________________________
____________
____________________________________________________________________
____________
____________________________________________________________________
____________
_________________________________________
____________
_____________________________________________________________
L. W
Where did yo
ou obtain thee applicationn?
_____ Counsellor at High School
S
_____ LULAC
C Council Noo.2/ Rey Feoo Scholarshipp Inc. Officee
_____ Rey Feo
o Scholarship Inc. Webssite
_____ Other: ___________
_
_________________
C Scholarshhip per studdent per yeear is
Note: Only one Rey Feo Scholarship or LULAC
mitted. Studeents may applly and receivee a Rey Feo Scholarship
S
foor up to four years.
y
perm
My signaature certifiees that to thee best of my knowledge that all the information provided onn this
form is true
t
and com
mplete. I herreby authoriize the LUL
LAC Councill No.2, Rey Feo Scholaarship
Committtee, Inc. to inquire andd verify alll informatioon necessaryy in the prrocessing off this
scholarshhip applicatio
on.
o all awards, assistancee and
If selecteed for a financial award, I authorize financiall inquiries of
actual monetary
m
trransaction sources
s
be released by
b the Finnancial Aid Office off the
College/U
University in
n which I am
m enrolled to
t the LULA
AC Council No. 2, Rey Feo Scholaarship
Committtee, Inc. upon
n their requeest.
Signature:
Date:
6
R Feo Scholarsh
Rey
S
hip, Inc.
&
An
n Educatioon Project of LULA
AC Counncil No. 2
League of United Latin Ameerican Citizzens
Corpporate Officee
1151
14 Jones Maaltsberger Rooad, San Anttonio, Texas 78216-28311
Phone (210) 403-99001 Fax (210) 403-90002
www.reyfe
feoscholarshiip.com
M. P
Please an
nswer th
he follow
wing questions too the beest of your
y
a
ability.
Pleease attach
h a separaate sheet of paper if needed.
a. Tell us about yourself too include your hobb
bies, person
nal values and
dream
ms/goals for your futture as a positive an
nd contribu
uting succeessful
indiviidual.
b. Tell us
u about yoour past, prresent, futu
ure involvem
ment as a volunteer
v
in
n the
comm
munity and what you are
a proud of
o the most and your accomplishm
a
ments
and personal
p
imp
pact as a volunteer and
d community service.
c. Tell us
u how you
u intend to utilize the degree an
nd skills you
u learn in your
choseen field of higher
h
education to further
fu
the good of Saan Antonio and
surro
ounding com
mmunity.
I certify thaat all of the inforrmation includedd in this applicattion is true and complete
c
and thhat I am not relatted to a memberr of the
Scholarship Committee or the President of the participatiing LULAC Couuncil to which I am applying. I agree not to accept
y Feo Scholarshhip as well as any
a other LULA
AC Council or LULAC
L
Nationaal Educational Service
S
LULAC Coouncil No. 2/Rey
Centers (LN
NESC) at the sam
me time for the same
s
semester/school year. I unnderstand this sccholarship is for tuition and bookks only
for the semester allocated and
a cannot be duuplicated by addditional scholarsships and grantss in which I am receiving. I auuthorize
investigationn of all statemeents contained in
i this applicatiion for a scholaarship as may be
b necessary inn arriving to an award
decision. This
T
application for a scholarshhip shall be conssidered active foor a period of tiime not to exceeed one (1) yearr. Any
applicant wishing to be con
nsidered for a schholarship beyonnd this time periood should inquirre as to whether or not applicatioons are
being acceppted at that time.
Signature of Applicantt
Datee
If an applicant is assistted in completing the appliication, the peerson who is assisting
a
the applicant
a
musst
also sign the
t applicatio
on.
Name of Person
P
assisting
g Applicant:
Address:
Ciity:
Telephone:
Statee:
Z Code
Zip
Mail com
mpleted app
plication and
d all required documen
nts to the ad
ddress below
w by the Maarch
st
31 dead
dline:
Rey Feo Sccholarship Com
mmittee, Inc.
Attn: RFS
SI Application
11514 Jonees Maltsbergerr Rd, San Antoonio, Texas 782216-2831
7
LULAC NATIONAL SCHOLARSHIP FUND
The LULAC National Scholarship Fund (LNSF) is a program of the LULAC National Educational Service Centers, Inc.
STUDENT APPLICATION
8
LULAC NATIONAL SCHOLARSHIP FUND STUDENT APPLICATION © 1/10
The League of United Latin American Citizens (LULAC) has considered education its number one priority since it was established in 1929.
As part of LULAC’s education efforts, the LULAC National Scholarship Fund (LNSF) was established in 1975 to provide scholarships to
Hispanic students attending colleges and universities. Under the LNSF program, local LULAC Councils, in partnership with local and
national businesses, award scholarships to students in their communities. LNSF is administered by the LULAC National Educational
Service Centers, Inc., (LNESC) a non-profit educational organization established by LULAC to provide educational programs for Hispanics
and other youth.
TERMS: LULAC Councils will award scholarships to qualified Hispanic students who are enrolled or are planning to enroll in accredited
colleges or universities in the United States. Awards start at $250. Awards of $500 and under are disbursed on July 15; awards over $500
are disbursed in two equal payments on July 15 and January 15. All awards are sent to the local LULAC Councils for distribution to
recipients. Scholarships may be used for the payment of tuition, academic fees, room, board, and the purchase of required educational
materials & books.
ELIGIBILITY REQUIREMENTS: Applicants must meet the following criteria to be considered for a scholarship:
• Must be a U.S. citizen or legal permanent resident
• Must have applied to or be enrolled as a full-time student in a college, university, or graduate school, including 2-year colleges, or
vocational schools that lead to an associate’s degree
• A student will not be eligible for a scholarship if he/she is related to a scholarship committee member, the Council President, or an
individual contributor to the local funds of the Council
AWARD CRITERIA: Applicants are eligible for the following three types of scholarship awards:
National Scholastic Achievement Awards ($2,000)
• The student has a GPA of 3.5 or better on a 4.0 scale or equivalent, and, if the student is an entering freshman,
• The student scores 29 or higher on the ACT test, or 1350 or higher on the SAT test.
Honors Awards ($500 to $2,000)
• The student has a GPA of 3.25 or better on a 4.0 scale or equivalent, and, if the student is an entering freshman,
• The student scores 23 or higher on the ACT test, or 1100 or higher on the SAT test.
General Awards ($250 to $1,000)
Grades and academic performance will serve as indicators of potential; however, emphasis may be placed on the individual’s
motivation, sincerity, and integrity, which can best be revealed through a personal interview and in the personal essay. Need,
community involvement, and leadership activities will also be considered.
APPLICATION PROCESS:
Applicants must submit the following in order to be considered for an LNSF scholarship:
• Completed and signed LNSF application form
• Verification of admittance or enrollment from the institution the student is attending or planning to attend
(i.e. -letter of acceptance, letter from the registrar, or a transcript)
• Typed, or neatly printed, personal essay of not more than 300 words
For consideration of an Honors or NSA award, entering college freshman must also submit:
• High School or college transcript with GPA
• Copy of ACT or SAT score report
TIME SCHEDULE Mail to LULAC Council below:
March 31: Application due to local LULAC Council _________________________________
May 15: Applicants notified of scholarship award by local LULAC Council _________________________________
July 15: First scholarship disbursement sent to local LULAC Council _________________________________
January 15: Second scholarship disbursement sent to local LULAC Council _____________________________________
¾ Completed LNSF application must be mailed to the local LULAC Council by March 31.
¾ Incomplete applications will not be considered for a scholarship.
¾ The LULAC Council to which you apply may require additional information and/or a personal interview.
¾ Applications are NOT accepted at the LNESC National 9Office.
LULAC NATIONAL SCHOLARSHIP FUND STUDENT APPLICATION © 1/10
Please type or print neatly and submit to the participating local LULAC Council in your area
Name ________________________________________________________________________________________________________
First Middle Initial Last
Address _______________________________________________________________________________________________________
Number Street
______________________________________________________________________________________________________________
City State Zip
Telephone Number: (
)
-
E-Mail:
Social Security Number __________ - _______ - ______________ Sex: ˆ Male • ˆ Female
Citizenship: ˆ U.S. Citizen • ˆ Legal Permanent Resident Date of Birth
_______/_____/_________
Ethnic Origin: ˆ Mexican • ˆ Puerto Rican • ˆ Cuban • ˆ South/Central American • ˆ other ______________________________
Parent/Guardian Name ____________________________________________ Phone (if different) ______________________________
Address (if different) _____________________________________________________________________________________________
Are you a LULAC Member? ˆYES ˆ NO
IF YES, PLEASE CHECK ONE: ˆ I am a Youth Member ˆ I am a Young Adult Member
IF NO, would you like a LULAC Representative to contact you regarding membership? ˆ YES ˆ NO
ACADEMIC DATA
High School ___________________________________ Date of Graduation _____________________ GPA/Scale ________________
College _______________________________________ Major ________________________________ GPA/Scale ________________
Current Standing (as of the date of this application): ˆ Not Enrolled • ˆ High School Senior • ˆ College Freshman
ˆ College Sophomore • ˆ College Junior • ˆ College Senior • ˆ Graduate Student
ACT/SAT Score: _________________ Class Rank and Size ___________________________________________________________
List honors, awards, extra-curricular activities, and community involvement (use separate sheet if necessary): _______________________
______________________________________________________________________________________________________________
______________________________________________________________________________________________________________
FINANCIAL DATA
Annual family income ___________________________ # in Family __________________ # Dependents in college _______________
College expenses for year of application: Tuition $ ________________ Room/Board $ _______________ Other $ _______________
Money available for college expenses: Parents $________Work $_________Savings $ Other $ ___________
Have you applied for student financial aid? ˆ Yes ˆ No Please list amount of financial aid already secured $ ___________________
FOR LULAC COUNCIL USE ONLY: Council #: _____________ Award Amount: ______________ Award Type: ________________
Check if the applicant has submitted the following: ˆ Signed & completed application form • ˆ Enrollment or admittance verification •
ˆ Personal essay • ˆ High school or college transcript • ˆ ACT or SAT score report
10
PERSONAL ESSAY
Please type or print neatly a statement describing the personal & career goals your studies are leading to. In addition, please
describe any community service activities that you have lead or participated in that relate to your future personal and career
goals.
Applicant’s signature required. Please read carefully, sign and date below:
I certify that all of the information included in this application is true and complete and that I am not related to a member of the Scholarship
Committee or the President of the participating LULAC Council to which I am applying for an LNSF Scholarship. I acknowledge that to
qualify for supplemental funds, a LULAC Council must be in good standing and that good standing is determined by LULAC National and
not LNESC. I further understand that LNESC is not responsible for any scholarship commitments made by LULAC Councils or their
members. I further understand that LNESC will not supplement scholarship applications submitted by LULAC Councils, which are not in
good standing with LULAC National.
____________________________________________
Signature of Applicant
Date
______________________________________________
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