This Preliminary Information Form is designed to give
us the data we need to conduct an Informational Interview.
Informational Interviews are not a part of the formal
application process; rather, they are designed to be an
information exchange between the Admissions Committee
and the applicant. Should you desire a Selection Interview,
please submit your formal application, either via paper
or online at triumemba.org.
Once the application has been checked to ensure it is
complete, we will review it and contact you should we
decide to extend an invitation to interview.
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Personal Information |
*Have you attended an information session? |
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| If yes, please enter date (mm/dd/yy): |
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| *Prefix: |
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| *First (Given)
Name: |
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| Middle Name: |
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| *Last (Family)
Name: |
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| *Date of Birth: |
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| *Gender: |
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| Country of Birth: |
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| *Citizenship (Dual citizenship if applicable): |
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* Home Address 1: |
(street address) |
| Home Address 2: |
(apt, suite, etc...) |
| *Town or City: |
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| State or Province: |
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| *Country: |
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| Zip or Postal Code: |
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| Home Telephone: |
(include country and city codes) |
| Mobile Telephone: |
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| Home E-mail: |
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| *I prefer all correspondence to be sent to my address at: |
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Home
Business |
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Employment Information |
| *Company: |
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| *Title: |
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| *Business Address 1: |
(street address) |
| Business Address 2: |
(plaza, building, etc...) |
| Business Address 3: |
(suite, floor, dept) |
| *Town or City: |
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| State or Province: |
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| *Country: |
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| Zip or Postal Code: |
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| *Business Telephone: |
(include country and city codes) |
| Business Fax: |
(include country and city codes) |
| *Business E-mail: |
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Education |
| *List, in chronological order, all colleges, universities
and other institutions attended since secondary school, including professional
and non-degree programs. Be sure to specify the exact date you received
your degree(s). If you need additional sheets, please mail or fax them
to the TRIUM Program office. Be sure to document all pages with your name,
address, and company name. |
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| Institution: |
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| Dates of Attendance: |
to
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| Major: |
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| Grade Point Average: |
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| Degree / Diploma: |
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| Date Received: |
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| Institution: |
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| Dates of Attendance: |
to
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| Major: |
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| Grade Point Average: |
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| Degree / Diploma: |
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| Date Received: |
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| Institution: |
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| Dates of Attendance: |
to
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| Major: |
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| Grade Point Average: |
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| Degree / Diploma: |
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| Date Received: |
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Activities |
| *List, in order of importance to you, hobbies, recreational
activities, clubs and memberships in professional and civic organizations. |
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*What prompted you to
visit our web site today? |
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| Please indicate which recruiting fair you attended: |
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| If your fair is
not listed above, please let us know which city
and what date you attended a recruiting fair: |
| City: |
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Date: |
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Upload a Resume |
| Resume: |
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The following statement should be read carefully,
to indicate your understanding and agreement, please
check the "I Agree" box, and enter your
name and today's date in the fields provided.
I hereby certify that the information on this form is accurate
to the best of my knowledge.
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| *I Agree: |
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| *Your Name: |
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| *Date: |
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Verification |
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To verify your submission please enter the text shown below:
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