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First Name

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Title

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Participant Email

Gender:     Female     Male

How did you hear about LEMIT Online?

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Mailing Address

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Course is $30 per person.

I will be paying by:

    Online by Credit Card or Electronic Check
    Paper Check/Purchase Order  (Check/PO # )

Please make checks payable to SAM HOUSTON STATE UNIVERSITY and mail to:

LEMIT
Attn: TBD
Sam Houston State University
Box 2417
Huntsville, Texas 77341-2417