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STUDENT INFORMATION
Gender
*
:
Male
Female
Birthdate
*
(mm/dd/yyyy)
:
01/01/1970
Mobile/Phone Number
*
:
/
Email Address
*
:
Student Category
*
:
Continuing Student
Applied Course
*
:
LRN
*
:
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*
:
NEW PASSWORD
*
:
NOTE:
Use 8 to 32 characters, and do not use your School ID
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:
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