| Term*: |
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| Name*: |
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| Student ID*: |
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| Address*: |
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| City*: |
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| Zip*: |
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| Phone Number*: |
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| Email*: |
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| Program Attended*: |
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| COURSE1*(check for the courses offered): |
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| COURSE TITLE*: |
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| INSTRUCTOR*: |
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| DAY/TIME*: |
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| UNITS*: |
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| COURSE2*: |
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| COURSE TITLE*: |
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| INSTRUCTOR*: |
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| DAY/TIME*: |
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| UNITS*: |
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| COURSE3*: |
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| COURSE TITLE*: |
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| INSTRUCTOR*: |
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| DAY/TIME*: |
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| UNITS*: |
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| COURSE4: |
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| COURSE TITLE: |
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| INSTRUCTOR: |
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| DAY/TIME: |
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| UNITS: |
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| COURSE5: |
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| COURSE TITLE: |
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| INSTRUCTOR: |
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| DAY/TIME: |
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| UNITS: |
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GENERAL INFORMATION:
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Academic Course Fee: $295/unit
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Registration Fee: $50/trimester
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Late Fee: $50
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Application Fee: $50
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Student Assoc. Fee: $10/trimester
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