Class Registration Form

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Class Registration
Name:
Date:
DOB:
Student ID No.
School:
Major:
Email:
Phone:
Address:
Class Name:
CRN:
Date(s):
Time(s):
Semester:
Credits:
Professor:
T.A.(s):
Building:
Room:
Prerequisites:
Equipment Required:
Disabilities/Special
Requirements:
¨ Per day
$
¨ Monthly installment $
¨ Full payment
$
¨ Total
$
¨ Check ¨ Cash ¨ Card ¨ Paypal
Acct./Card No.
Exp.
Terms and Conditions
Signature
Date

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