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* 1. Contact Information

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* 2. SESSION A: JULY 9 - JULY 26 
Please choose 1 workshop. Note that you cannot take Basic Algebra without receiving a score of at least 78 in Arithmetic. Please note the dates each workshop will run and choose ONE time. (morning OR afternoon start time)

  Session A: Basic Reading/Writing (July 9 - July 26, Mon. through Thurs.) Session A: Basic Math (July 9  - July 26, Mon. through Thurs.) Session A: Basic Algebra (July 9 - July 26, Mon. through Thurs.)
9:00am-2:00pm
12:00pm-5:00pm

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* 3. SESSION B: AUGUST 6 - AUGUST 23
Please choose 1 workshop. Note that you cannot take Basic Algebra without receiving a score of at least 78 in Arithmetic. Please note the dates each workshop will run and choose ONE time. (morning OR afternoon start time)

  Session B: Basic Reading/Writing (August 6 - August 23, Mon. through Thurs.) Session B: Basic Math (August 6 - August 23, Mon. through Thurs.) Session B: Basic Algebra (August 6 - August 23, Mon. through Thurs.)
9:00am-2:00pm
12:00pm-5:00pm

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* 4. Enter your Accuplacer Test Scores for the subjects you wish to take in the Summer Bridge Program. (If you do not know them, please enter "0" on all lines)

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* 5. High school graduation or GED date

Date 

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* 7. Gender

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* 8. Are you married?

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* 9. Do you have children?

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* 10. What is your ethnicity? (Please select all that apply.)

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