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DISTRIBUTED GRADUATE STUDIES

Fall 2000, REGISTRATION FORM



NAME_______________________________________________ SOC SEC NO _______________________

STREET / APT ADDRESS ___________________________________________________________________

CITY, STATE, ZIP __________________________________________________________________________

WORK PHONE _____________________________ HOME PHONE _________________________________

WORK EMAIL ______________________________ HOME EMAIL _________________________________


DEGREE INTEREST: (CHECK ONE)

COURSE REGISTRATION : List the courses you want to enroll in. Continuing Studies will be notified and billings and other information will follow. If other than 3 credit hours, show the number of credit hours you are registering for. Use this space for distance/distributed courses only. Click here to view Spring 2000 courses.


COMPUTER INFORMATION: Mac or PC? ______ CD: Yes or No? ______ Diskettes: Yes or No? ________



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