BIOL 4104 Histology Form

 

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*First Name

*Last Name

*Student ID Number

*Local Phone or Cell Number

*LSU Email Address

*Student Degree

*Anticipated Graduation Date

*Request for SEMESTER / YEAR

*TOTAL number of hours EARNED

Prerequisite: BIOL 3090

BIOL 3090 CompletedCurrently Enrolled in BIOL 3090Have not taken BIOL 3090

If BIOL 3090 completed, list grade received:

Prerequisite BIOL 3156

BIOL 3156 CompletedCurrently Enrolled in BIOL 3156Have not taken BIOL 3156

If BIOL 3156 completed, list grade received:

Permission to be unenrolled from conflicting course(s). (Type "Permission Granted")

*I authorize that all information provided on this form, including any and all personal and academic data may be shared with the LSU Department of Biological Sciences Undergraduate Office to be considered for admission into the respective course(s). This data will be securely retained for a period not to exceed three (3) months. To learn more about privacy at LSU, please see the LSU Privacy Statement (www.lsu.edu/privacy).

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