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UMD Gemstone



Name: UID:
Email: Phone:
Yr Entered Gemstone: Home State:
Campus Address: Are you working in a team? Yes    No
Team Name:
Mentor Name:
Why do you wish to discontinue participation in the Gemstone Program?
(Please select the reason and briefly explain)
Academic Reasons
Personal Reasons
Financial Reasons
Transferring to another University
University Name:    State: 
Other
 

 

   
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