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Verification of Enrollment
Receipt of Syllabus
(Actual enrollment in this course can only be validated by the Registrar.)
Please complete the information requested below
and return this form to the instructor.
Name: _______G__w_e_n_d_o_ly_n_M__a_x_o_n_____ J-Number: _____j0_0_7_0_9_2_2_8____
Course No./Section___C_L_L__3_0_1_-7__1__ Course Title: _P_r_in_c_i_p_le_-_C_e_n_t_e_re_d__L_e_a_d_e_rs_h_ip
Semester: ______F_a_ll_____ Year: ______2_0_1_8______
By checking the box and entering my date of birth, I acknowledge the receipt of a syllabus
for the above course.
_G_w__e_n_d_o_l_y_n_M__a_x_o_n_(_0_8_/_2_7_/_1_9_73) _1_0_/1_9__/1_8_______________________
Electronic Signature (Date of Birth) Date