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Last Name :
First Name:
School Name:
Street Address:
City, State/Province & Zip:
Phone Number:	(ex.:773-262-5810)
Fax Number:	(ex.:773-262-5810)
E-mail:

I am a :	H. S. Counselor Independent Counselor College Admission Officer Parent Other (specify):

I will pay by :	Credit Card at the individual subscriber rate of $59 for one year Credit Card at the individual subscriber rate of $100 for 2 years Check or Purchase Order at the individual subscriber rate of $59 for one year Check or Purchase Order at the individual subscriber rate of $100 for two years
	As an individual subscriber, I pledge not to share the collegeboundnews.com access code with anyone outside my immediate family. I understand that to share the code is a copyright violation.