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THE ADMINISTRATOR | 73


                                State University Foundation

                                   1234 Philanthropic Avenue

                                      Gulf City │ LA 72503


                                  Board Application Form


          Date:                   Nominator:
                                                      (if applicable)

          Name:

          Telephone:                            Email:

          Address:

          Relevant experience and/or employment (attach a resume if relevant):







          Why are you interested in SU Foundation?







          Area(s) of expertise/contribution you feel you can make:
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