Lari LaBello (309) 999-4651 Downtown Peoria Campus 201 S. W. Adams Street Peoria, IL 61635-0001
Student (Legal) Name (type or print) ______________________________
___________________________
Address _____________________________________City_______________Zip_________ Current Year in School SOPH JUN Gender: Phone #
Social Security # ________ - _______ - __________
Male
Female
(home) ____________________
Date of Birth: ______________________
(cell) __________________
(other) _______________________
Student Email: ____________________________________________________________________ High School:
________________________________
School Phone #
____________________
School Address: ___________________________________________________________________ Counselor Name: _____________________________
Counselor Email: ____________________
Specific health and immunization requirements will be necessary prior to start of class. 2016/17 Options for Work-Based Learning/Dual Credit Health Occupations Program Due 1/31/16 FALL SEMESTER Monday through Friday, 7 a.m.-10 a.m., ICC North Campus Monday through Friday, 7 a.m.-10 a.m., Eureka AC Home Monday through Friday, 7 a.m.-10 a.m., Pekin SPRING SEMESTER Monday through Friday, 7 a.m.-10 a.m., ICC North Campus Monday through Friday, 7 a.m.-10 a.m., Eureka AC Home Monday through Friday, 7 a.m.-10 a.m., Pekin Please indicate your preference of semester and location by selecting ONE of the above. Parent/Guardian: Name: ________________________
Phone # ______________
Email _____________________
Required Signatures: Signing below indicates that student wishes to be considered for the Work-Based Learning/Dual Credit Nursing Assistant Program at ICC. Parent/Guardian signature indicates they believe that their son/daughter has the maturity and ability to be successful in the program, approves of this application, ensures students will be provided suitable transportation, and gives the school permission to release all necessary school records. The student/parent/guardian understands that, in compliance with federal and state privacy laws, ICC may use biographical information for institutional research. We understand that withholding information or giving false information may make a student ineligible for admission to ICC or subject to dismissal.
WG-Applicationb for WBL with lines - healthoccapp2016a.pdf ...
Page 1 of 2. Lari LaBello (309) 999-4651. Downtown Peoria Campus. 201 S. W. Adams Street. Peoria, IL 61635-0001. WBL App.doc/1. Student (Legal) Name (type or print) ...
Page 1 of 5. Page 1 of 5. Page 2 of 5. Page 2 of 5. Page 3 of 5. Page 3 of 5. RoboCop with Folding Lines (by Cepot Patel).pdf. RoboCop with Folding Lines (by Cepot Patel).pdf. Open. Extract. Open with. Sign In. Main menu. Displaying RoboCop with Fold
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example throughout the paper to illustrate and compare our two approaches for pairwise testing. The FM was added to the FM repository on the SPL. Online ...