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Receivers Last Name :
Receivers First Name:
Your Institution's Name:
Your Official Position:
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 :	High School Counselor/Teacher/Administrator College Admissions Officer/Administrator Other (specify):

I will pay by :	Credit Card at the institutional subscriber rate of $100 for 1 year Credit Card at the institutional subscriber rate of $150 for 2 years Check or Purchase Order at the institutional subscriber rate of $100 for one year Check or Purchase Order at the institutional subscriber rate of $150 for two years
	As an institutional subscriber, we pledge not to share the collegeboundnews.com access code with anyone outside our institutional community.