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Last 4 Digits of PID
First Name
Last Name
Email
Phone Number
Example: 517-123-4569
Major
Class Level
Freshman
Sophomore
Junior
Senior
Graduate Student
Lifelong Student
Semester & year of Graduation
For Graduate and Lifelong please leave blank.
BLD Course Number
BLD 000 - No Course
BLD 204 - Mechanisms of Disease
BLD 213 - Applic of Clinical Lab Prin
BLD 220 - Health Careers Preparation
BLD 324 - Fundamental Heme, Coag, Urine
BLD 324L - Intro Lab in Heme/Coag/Urines
BLD 413 - Adv BLD Lab
BLD 414 - Laboratory Analysis & Practice
BLD 416 - Clinical Chemistry
BLD 417 - Quality in Lab Testing
BLD 424 - Adv Heme/Coag/Urinalysis
BLD 424L - Adv Lab in Heme/Coag/Urines
BLD 430 - Molecular Lab Diagnostics
BLD 433 - Clin Immuno & Immunohem Lab
BLD 434 - Clinical Immunology
BLD 435 - Transfuse Transplant Medicine
BLD 436 - Prin Diag Molecular Science
BLD 437 - Clin Appl Diag Nolecular Sci
BLD 438 - Molecular Diagnostic Lab
BLD 442 - Ed & Mgt in Clin Lab
BLD 450 - Eukaryotic Pathogens
BLD 455 - Integ Clin Lab Sci Discip (W)
BLD 471 - Adv Clinical Chemistry Lab
BLD 472 - Adv Clinical Chemistry
BLD 473 - Adv Clin Hemat & Body Fl Lab
BLD 474 - Adv Clin Hemat & Body Fluids
BLD 475 - Adv Clin Immun & Immunohem Lab
BLD 476 - Adv Clin Immun & Immunohem
BLD 477 - Adv Clinical Microbiology Lab
BLD 478 - Adv Clinical Microbiology
BLD 479 - Prof Behavior in CLS
BLD 495 - Directed Study-007
BLD 495 - Directed Study-006
BLD 495 - Directed Study-004
BLD 495 - Directed Study-003
BLD 495 - Directed Study-002
BLD 495 - Directed Study-001
BLD 495 - Directed Study-005
BLD 498 - Focused Problems in CLS
BLD 498L - Infectious Disease Diagnostics Laboratory
BLD 801 - Biomedical Lab Diagnostics Seminar
BLD 811 - Fundamentals Sci Research
BLD 815 - Cell Biology Health/Disease I
BLD 816 - Cell Biology Health/Disease II
BLD 830 - Concepts in Molecular Biology
BLD 831 - Clin Appl of Mol Biol
BLD 832 - Molecular Pathology Lab
BLD 835 - Hemo/Thromb & Resource Mgmt
BLD 842 - Managing BMLO
BLD 844 - Topics in BMLO
BLD 846 - Decision Processes for BMLO
BLD 850 - Concepts in Immunodiagnostics
BLD 851 - Clin Apps of Immuniodiagnostics
BLD 852 - Immunodiagnostics Laboratory
BLD 890 - Sel Prob Clinical Lab Sciences
BLD 895 - Projects in BMLO
BLD 899 - Master's Thesis Research
MMG 463 - Medical Microbiology
MMG 464 - Diagnostic Microbiology Lab
Section Number
(if no preference type "any")
example: 730 (3-digit number)
Course Semester
Fall 2013
Summer 2013
Spring 2014
Reason for Request
Approval of Dept Required
Course/Section is Full
Degree level and course level are different
My major is not BLD/CLS/DMS
Prerequisites not satisfied
Other
Have you completed all the prerequisites?
Yes
No
If No, what prerequisites are still needed
(Please list courses and separate with commas)
Will you be transferring any prerequisites?
Yes
No
If Yes, what prerequisites are in transfer?
(Please list courses and separate with commas)
Additional Comments
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