Your Contact Information
Your Name
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First Name
Last Name
Your Department/Office
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Email Address
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Your Preferred Phone Number
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Area Code
Phone Number
Your Job Classification
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Full-Time Faculty
Associate Faculty
Classified Staff
MSC Member
In submitting this application, I acknowledge that attendance is required at both days of the 2 - Day On Course Workshop: Friday & Saturday, January 22 + 23, 2016.
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I will attend both days of the 2 - Day On Course Workshop.
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