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Personal Information

First name(s)

Last Name

Email Address

Backup email address

Contact telephone number:

Date of Birth

Current Status

Institution

Other: Institution name

Major/Concentration

What is your time zone?

Address

Organization

Street Address

City

State/Province

Country

Post code

Academic Information

Language level

Are you planning to transfer credit to your home institution?

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Personal introduction

Please introduce yourself (in 200 words or less) to your instructor and your classmates.

Is it OK for us to share your email address with your classmates?

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How did you hear about us?

Learning Credit group members

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