Nicholls State University

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CROWN Interest Form

We welcome you to submit your information below if you are interested in learning more about CROWN.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Phone

Are you currently enrolled at Nicholls State University?

Classification

Major

Are you interested in working with CROWN as a mentor?

When do you plan on enrolling at Nicholls State University?

Please tell us why you are interested in joining CROWN.

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