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Full Name (including middle initial):
email Address:
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* Employer Information is confidential and will only be used for statistical purposes.
Semester:	(ex. Spring 2005)
Are you a candidate for graduation this semester? Yes No

CLASSES TO BE ADDED:
	Dept.	Course	Div/Sec	Title	Day or Night
example=>	OLS	252Y	02/01	Human Behavior in Organizations	Night







CLASSES TO BE DROPPED:
	Dept.	Course	Div/Sec	Title	Day or Night







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Lafayette
5500 State Road 38E, AD 2900
Lafayette, IN 47903

Phone: (765) 496-6886
Email: techlafayette@purdue.edu

College of Technology
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West Lafayette, IN 47907

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