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Get Leeward Community College Admissions Form

School Students Only) Social Security No: Legal Name: PRINT Last Name, First Name, Full Middle Name Mailing Address: Street/P.O. Box Home Phone: Female Male City Cell Phone: Birth Date / / State Zip Code Email Address: USA Citizenship Permanent Resident (submit copy of Resident Card) Other Birth Place specify country Were any of your ancestors Hawaiian: Yes No Ethnicity: (see back for code) specify state or foreign co.

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