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2009-2010 XEROX TECHNICAL MINORITY SCHOLARSHIP APPLICATION
|TO STUDENT: Please complete the following information based on the current school year. All applicants must be full-time studentsenrolled at a four-year |
|institution to be eligible. Deadline for submission of this application, including resume, should be postmarked before September 30, 2009. Be sure to verify ||that your institution has properly and fully completed the bottom portion of this form. Note: Spouses and children of Xerox employees are not eligible for this|
|program. NO APPLICATIONWILL BE PROCESSED WITHOUT APPLICANT RESUME ATTACHED. |
|Last Name, First Name, Middle Initial|Social Security Number |Date |
|School Street Address City, State, Zip School E-mail Address School Phone (Area Code)|
|     |
|Home Street Address City, State, Zip Home E-mail Address Home Phone (Area Code)|
|      |
|US Citizen orPermanent Resident? | Black Native American | Male |
|Yes No|American/Alaskan Hispanic |Female |
| |Asian/Pacific Islander...
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