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Student Data Form

Contact Information
How will the course be paid?
Course Title
Course Code
Course Fee
a.      Online Course: You may choose your own start date. However, please know that it may take 4 weeks for WIOA counselors to complete the documentation, so keep that in mind when choosing a start date.
b.      Live Course: put the date listed for the course.

You must choose a course start date:
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