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Registration. Name SS# (last 4 digits) Department Building If off-campus, include city, state, ZIP Work telephone Official job title Email address Course title Date of program Training code # Time of program For classes offered more than once per quarter, please check ONE box at right. I request enrollment ONLY on the class date listed above I will accept enrollment in any available class with title listed above I understand if I leave my work area during working hours to attend.

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