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APPLICATION TO HOLD A SPACE IN CLASS
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Email
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Birthdate
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Age
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Birthplace
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Gender
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M
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F
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Citizenship Status:
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Permanent Resident
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Other (Please Specify)
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US Citizen/National
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Educational Data
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Select the Highest Grade Completed:
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Last School Attended
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Course Program Requested
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Part-Time Class Dates
Mon, Wed, Fri, (6 - 10 pm)
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Full-Time Class Dates
Monday - Friday (9 am - 2 pm)
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How did you find CalCopa? *(Check all that apply)
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Check here to pay the
$100 Registration Fee?
(non-refundable)
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Comments, or
Elective Requests
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