Student Verification Form

Please fill out the following form in order to receive the college student rate. Your information will not be used for any other purpose or shared. Validation purposes only.

First Name

Last Name

Email

Date of Birth

What is your current student status? *

Undergraduate

Graduate Student

Recent Graduate

Doctoral Student

If you are a student, what year are you enrolled in?

First

Second

Third

Fourth

Fifth+

What college or university do/did you attend?

Please provide your student ID number and school email address.

I declare that the info I’ve provided is accurate & complete

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