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Name
First
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Last
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(If you are submitting this form on behalf of a child under the age of 18)
Child's First Name
Child's Last Initial
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City
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County
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Email (internal use)
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Phone Number (internal use)
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Phone Type
Mobile
Home
Office
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West Virginia State Treasury Program that had an impact on your life
Hope Scholarship
SMART529
Jumpstart Savings Program
WVABLE
Get a Life
WV457 Retirement Plus
Unclaimed Property
In your own words, describe how this program has positively impacted your life
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Attach a picture (optional)! (.png,.jpg,.jpeg,.gif,.pdf,.heic,.heif,.webp,.bmp,.tif)
By checking this box and submitting this form, you are agreeing to the
West Virginia State Treasurer’s Office Media Consent and Release Form