General Information
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REQUEST FOR RE-ENTRY / RE-START APPROVAL
TO BE COMPLETED BY FORMER STUDENT WHO IS REQUESTING READMISSION
Your Name
Home Address
Phone number
Email
Email address that you check frequently
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Campus
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Riverside
West Covina
Fairfield
Rancho Cordova
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Program
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Electrical Training Program
HVAC Technician
Solar Installation Hybrid Program
Medical Assistant
Pharmacy Technician
Business Office Administration
AAS Degree Business Administration
Cyber Security Specialist
AAS Degree Cyber Security
Behavioral Health Assistant
Alcohol & Drug Counseling Studies
AAS Degree Substance Use Disorder Counseling
BAS Addiction Studies
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IS IT YOUR DESIRE TO SEEK TRAINING RELATED EMPLOYMENT AS SOON AS YOU GRADUATE?
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OTHER COMMENTS FROM STUDENT
Date
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BY SIGNING I CERTIFY THE INFORMATION ABOVE OF IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE.
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