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Registrar

Clinic Registration Form

Use this form during the early registration and course request periods only. Be sure to complete all requested information. When choosing Clinics from the drop-down boxes below, be sure to do so in your order of preference.
 

* = Required Field

 
* First Name:
 
* Last Name:
 
Class Year:
 
Student ID: What is this?
 
Address Line 1:
 
Address Line 2:
 
City:
 
State/Province:
 
Zip/Postal Code:
 
Country:
 
Work Phone:
 
Home Phone:
 
Fax:
 
* Email:
(A valid email address is required.)
 
Choose your clinic (Clinic for Asylum, Refugee, and Emigrant Services (CARES), Civil Justice Clinic, Farmworker Legal Aid Clinic, and Federal Tax Clinic) in order of preference. The first being your 1st choice and the last being your last choice:
 
 
 
 
 
 
If you are applying for the CARES Clinic, you must submit a written application and a copy of your resume.  Click here for the CARES application.
 
Additional Comments:
 
 

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