EDU Form
For use in Firefox NOT Chrome. |
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* = Required Fields |
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*Hello this is ____ with Go College Degree.
The reason for my call is that you recently showed interest in furthering your education.
*This call is being recorded for quality assurance. |
*First Name  |
Ex. John |
| *Last Name |
Ex. Smith |
| *Phone |
Ex. 4084567890 |
| *Mobile/ Work Phone |
Ex. 4084567890 |
| *Email |
Ex. johnsmith@gmail.com
Please enter in a valid email.
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| *Address |
Ex. 122 South St |
| *City |
Ex. New York |
| *State |
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| *Zip |
Ex. 92651 |
| *Date of Birth |
Ex 02/22/1995. (Max age: Current year minus 60. Minimum: Current year minus 18.) |
| *Gender |
M
F
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| U.S. Citizen |
Y
N
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| U.S. Military Affiliation |
Y
N
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| Diploma or GED Year |
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| *Level of Education Attained |
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| *Course Area of Interest |
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| *2nd Course Area of Interest |
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| Internet Access |
Y
N
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| Start Date |
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| Employment Status |
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| *TCPA statement |
Mr. /Mrs.
the phone number we are on is
Double Click ONCE for Dashes
and Go College Degree and the school or schools you agree to be contacted by need your express permission to contact you in future if required by using SMS, phone calls and prerecorded messages with automatic telephone dialing system even if the number is a wireless number or on any federal or state do-not-call list. Please reply “Yes” to provide your consent." (Answer must be YES/Yeah. If No, then go to Courtesy Close.) |
| *Lead Source |
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| Lead IP |
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| Time Stamp |
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| There are some fields which need to be properly completed to submit the form. Please scroll up and fix all the fields in yellow text. Thank you! |
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