Registrant Details |
First name: |
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Middle Name: |
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Last name: |
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Address: |
Street Number and Name |
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City: |
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State: |
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ZIP: |
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Gender: |
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Age: |
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Day/Night Phone: |
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Email: |
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Have you studied Chinese before? |
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If yes, please answer the following
How long? |
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Where/at what school? |
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Please indicate the course you want to take (include course code) from the course listings: |
Course Number: |
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Course Title: |
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Course Fee: |
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How did you hear about us? |
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