Basic Information

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* 1. Full Name

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* 2. Date of Birth

Date

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* 3. Address

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* 4. Phone number

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* 5. Email address

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* 6. How did you hear about this class?

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* 7. Have you previously participated in the Lincoln Manufacturing Council Manufacturing Basics Certificate (Level 1, the 6-week program)?

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* 8. Have you previously participated in the Lincoln Manufacturing Council Manufacturing Skills Certificate (Level 2, at The Career Academy)?

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