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Berkeley Institutes on Higher Education
Summer 2012 -- July 9 - 13, 2012
Application Form

Home | Application | Program Information | Faculty and Associates

Clark Kerr Institute on Higher Education Summer 2012
Application Form

Space is limited and we urge you to submit application as soon as possible to assure your participation and to facilitate visa applications.

(All fields are required to be filled in!)

Name:
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Gender: Male Female

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Educational and Professional Background (including highest degree attained):
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Describe the reasons for your interest in the Institute, and how you believe it will help your career:

English Proficiency - The Institute will be conducted in English. Please state your proficiency in both written and spoken English on a scale of 1-10 (Excellent = 10 and Poor = 1):

How did you hear about the Berkeley Institutes on Higher Education?