Pack Family Regions Participation Form
Thank you for your interest in the Pack Family Regions program. Please complete this form to keep you informed about news and events on campus and in your region.  Go Pack!
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Last Name *
First Name *
Address *
City *
State *
Zip *
Email Address *
Cell Phone Number *
Student's Name *
Student's Classification *
Required
Identify your region from the following: *
If you live in North Carolina, please indicate your county. If you are an out of state family, please put N/A. *
What are your interests within the Pack Family Regions Program? *
Required
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