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*Please only fill this out AFTER speaking with one of our sales representatives

Your Course Information

Is this an emergency?
 Yes, I have something due tonight! No, nothing is due tonight

What class subject?

When is the first (or next) assignment due?

When is the last day of class (final exam date)?

Other important dates we should be aware of:

Total fee:

Your salesperson:

Your Personal Information

Your First Name (required)

Your Last Name (required)

Your Email Address (required)

Your Phone Number

Login Instructions

Online Course Web Address (URL)

User ID

Password

What is the course prefix (example: ACG2021)

What is the name of the course? (example: Accounting for Decision Makers)

Any additional login instructions?

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