Request for Cross Enrollment in Adult Studies Courses for Traditional Students
Last Name: *
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First Name: *
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ID Number: *
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NCWC email address:
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Telephone Number: *
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Age: *
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Current Class Status: *
Grade Point Average: *
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Expected Graduation Date: *
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Major(s)/Minor(s): *
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Course Number and Section Number: *
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Reason for requesting enrollment: *
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Academic Advisor Name: *
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Please print your name below to serve as your signature that you are requesting approval to take the above course: *
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