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A decision can be made, it is necessary for you to complete this form, sign and date it at the bottom, and return it to the Admissions Office. Place an X on the lines in front of the area(s) that represent what you were doing during the time period . Be sure to account for this entire timeframe. If the entire timeframe is not accounted for, it will be necessary to return the form to you thus delaying a decision on your application. Provide detailed explanations where indicated and.

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