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| Name of Center: SDSU ___ or ________________________ | Date of Exam: |
| Family Name | First Name | Middle Name |
| Address |
| City | State | Zip Code | Country |
| Academic Institution | Business |
| Phone number | FAX number |
| E-mail address |
| Citizen of what country (s)? | Red ID or Social Security # |
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How many upper division Spanish courses have you completed? _________ Did you study abroad? ____________ Where? ________________________ For how long? ___________________ |
What is your class level? Senior ___ Junior ___ Grad ___ |
Please print, fill out and mail in this application.
EXIGE
SDSU/CIBER
5500 Campanile Dr.
San Diego CA 92182-7732