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VALPARAISO UNIVERSITY APPLICANT – SELF-IDENTIFICATION FORM As part of the Valparaiso University application process, complete Section A below. SECTION A - GENERAL INFORMATION – PLEASE PRINT Applicant Name: _________
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Document Date: 2014-08-28 17:56:37

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Continent

Africa / Europe / /

Country

United States / Guam / Vietnam / /

Facility

Chapel Drive / Valparaiso University / /

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IndustryTerm

career services / /

MedicalCondition

Hearing Impairment / /

NaturalFeature

Pacific Islands / /

Organization

Department of Defense / office of Human Resource Services / VALPARAISO UNIVERSITY / /

Position

Affirmative Action Officer / Secretary / A - GENERAL / Executive / /

ProvinceOrState

Indiana / Hawaii / Alaska / /

Region

North America / Far East / Middle East / North Africa / Central America / South America / Southeast Asia / /

SocialTag