hey! i NEED you to fill this out ASAP!! its for cipp registration.

Grade:
Military Status and Branch:
Birth date:
First name
middle name
last name
address
city
state
zip
phone
email

Emergency Contact:
First and last name
Phone
email
address
city
state
zip
relationship

Grade: freshman
Military Status and Branch:
Birth date: 2-19-87
First name Mary
middle name Elizabeth
last name Rousis
address box #1640
city farmville
state va
zip 23090
phone x4188
email mer786@longwood.edu

Emergency Contact:
First and last name William Rousis
Phone (540) 362-2284
email wtrousis@aol.com
address 6731 Stonington Road
city Roanoke
state Va
zip 24019
relationship father

Grade=freshman
birthday=11-03-1986
Elizabeth
Rose
Mangano
Longwood University Box NO. 1117
Farmville, VA 23909
(804)-307-9788
Emergency Contact
Laura Mangano
(804)304-0873
842 Clubcrest Blvd. Chester, VA 23836
she's my mom

Grade: freshman (13)
Military Status and Branch: n/a
Birth date: 02/11/1987
First name: Samantha
middle name: Nicole
last name: Ruedinger
address: Box 1996 Longwood University
city: Farmville
state: VA
zip: 23909
phone: 434-395-4210(dorm) ; 703-728-4412(cell)
email: snr647@longwood.edu

Emergency Contact:
First and last name: Ralf and/or Phyllis Ruedinger
Phone: 703-444-5148
email
address: 74 Rutherford Circle
city: Sterling
state: VA
zip: 20165
relationship: father and mother

Grade: freshman
Military Status and Branch:n/a
Birth date:June 2, 1987
First name Ashley
middle name Lauren
last name Diehl
address Box No. 523
city Farmville
state VA
zip 23909
phone (434)3953829-room; (804)4758933-cell
email ald722@longwood.edu

Emergency Contact:
First and last name Tom Diehl
Phone (804)6391475-home;(804)8336994-cell
email tdiehl@vcu.edu
address 15105 Powell Grove Rd
city Midlothian
state VA
zip 23112
relationship dad

Grade: Junior
Military Status and Branch:N/A
Birth date: 3-12-85
First name Kristin
middle name Leigh
last name Harris
address 412L Suncase Blvd
city Farmville
state Va
zip 23901
phone 540-871-7243
email klharris@longwood.edu

Emergency Contact:
First and last name: Charlie and Flo Harris
Phone 540-297-5180
email
address 1345 Ayers Rd.
city Moneta
state VA
zip 24121
relationship Parents

Grade: Freshman
Military Status and Branch: n/a
Birth date: October 6, 1987
First name: Sabrina
middle name: Dawn
last name: Herborn
address: P.O. Box 1306 (206 South Ruffner)
city: Farmville
state: Virginia
zip: 23909
phone: 757-620-6861
email: SH039@longwood.edu

Emergency Contact: Sister
First and last name: Kimberly Herborn
Phone: 757-620-6860
email: ksherbor@longwood.edu
address: 611A Oak Street
city: Farmville
state: Virginia
zip: 23901
relationship: Sister

Grade: Junior
Birthdate:9/15/1985
First Name: Whitney
Middle Name: Marie
Last Name: Clayton
Address: longwood university, box 303
City: Farmville
State: VA
Zip: 23909
Phone: 703-915-0526
Email: wmc429@longwood.edu

Emergency Contact
Address: 5 Rheims Court, Sterling, VA 20164
Relationship: Mother, Deborah Clayton
Phone: 703-444-5043

Grade: Sophomore
Military Status and Branch:
Birth date: 7/24/86
First name Marilyn
middle name Kathleen
last name McKee
address 1512 Lea View Ave
city Norfolk
state VA
zip 23503
phone 4346076095
email mkm212@longwood.edu

Emergency Contact:
First and last name James R McKee
Phone 7575880786
email
address 1512 Lea View Ave
city Norfolk
state VA
zip 23503
relationship Father

Grade:freshmen
Military Status and Branch:none
Birth date:10/20/86
First name: Ninamarie
middle name: Celeste
last name: Elliott
city: West Chester
state: PA
zip: 19380
phone: 610 436 8069
email: nce830@longwood.edu

Emergency Contact:
First and last name: Stephen and Annamarie Elliott
Phone: 610 436 8069
email:
address:1257 Palomino Drive
city : West Chester
state: PA
zip: 19380
relationship: parents

Grade:freshmen
Military Status and Branch:none
Birth date:03/26/87
First name: Heather
middle name: Marie
last name: Turner
city: Haymarket
state: VA
zip: 20169
phone: 703 402 9829
email: hmt104@longwood.edu

Emergency Contact:
First and last name: Ron or Yasmina Turner
Phone: 703 754 2459, 703 402 9834, 571 334 9785
email:
address:14380 Dowden Downs Dr
city : Haymarket
state: VA
zip: 20169
relationship: parents
Email: hmt104@longwood.edu

ICQ:

Grade:Freshman
Military Status and Branch:none
Birth date:12/09/86
First name: Hailey
middle name:Mae
last name:Peters
address:Longwood University Box No. 1327
city:Farmville
state:VA
zip:23909
phone: 434-395-4168
email: hmp043@longwood.edu

Emergency Contact:
First and last name; Janis Peters
Phone: 703-754-1667 or 703-209-1825
email: Janisbeyes@aol.com
address: 8003 Rocky Run Rd.
city: Gainesville
state: VA
zip: 20155
relationship: Mother