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Please Complete the Following:

1. First Name
2. Last Name
3. Phone Number
4. E-Mail Address
5. Do You Currently Attend UCM?
Yes    No   
6. Have you previously attend UCM?
Yes    No   
7. Have you attend other colleges/universities?
Yes    No   

8. Approximately how many college credits have you earned?
9. I am primarily interested in taking courses:
10. Would you like an academic advisor to contact you to discuss the General Studies program at UCM?
Yes    No