Full Name:


TSU Student ID Number:


Do you usually attend classes at RRHEC or TSU?
RRHEC
TSU

Phone:
(home)
(work)
(cell)

E-mail:


Address/ZIP:



Major:


Courses Completed/Date of Completion:
(Include classes currently in progress)
(MM/DD/YYYY)
EDA 5339
EDA 5340
EDA 5345
EDA 5347
EDA 5348


Note: Only Educational Leadership majors may participate in the Level One Assessment.
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