Encore Campus 2012-2013 Course Proposal

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1. Instructor Name:
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2. Phone (nnn-nnn-nnnn):
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3. Email:
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4. Credentials
5. If you are a new instructor or if you have a new address, please complete the following (You only need to enter this information once):
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6. How did you hear about our program?
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7. Is this a new course?