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INDIVIDUAL LEARNING SKILLS REQUEST

Today's Date:

Name:
Alpha (m##...):
Company:
e-mail:
 
I am requesting assistance in the following areas:
(Please check all applicable areas)

Learning Skills
Time Management
Class Note-taking
Reading 
Review
Test Taking / Test Anxiety
Other 

Source: (how were you referred?)
Self-Referred
Recommended by a Peer/Upper Classman
Recommended by an Instructor   - Class 
Directed by Academic Board/ Advisory Board 
Directed by Company Academic Officer 
Directed by Company Officer


You will be assigned a tentative appointment upon receipt of this request. Please monitor your e-mail for your appointment time.  If you have not heard within 48 hours of your request, 
please contact the Learning Skills Department directly at 3-2936
 

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