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Date:
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Name:
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Payroll
Number:
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Home address:
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E-mail address:
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Phone number:
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Department:
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Position title:
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Name of Institution to attend:
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Course name:
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Start Date:
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End Date:
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Cost:
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Mark the box below that most describes the field of study that you are pursuing.
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Business, Commerce,
Management
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Fine Arts and Applied
Arts
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Engineering
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Liberal Arts, Social
Sciences
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Technology-Engineering
and Science Related
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Biological and Life
Sciences and Health
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Physical Science and
Math
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Education and Related
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If courses are leading to a degree, professional certificate or license please state below.
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State briefly how you believe the above course(s) may improve your skills:
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In addition to this application you must submit all supporting documentation by mail
or in person to Jessica Carpio, USS-POSCO Industries, 900 Loveridge Road, P.O.
Box 471, Pittsburg, CA 94565
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I authorize the Institution listed above to release any information requested by
UPI Career Development regarding tuition paid, benefits or scholarship aid
received, or completion of courses.
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