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BGSU - Writing Center

Writing Center Intake Form

Directions: Prior to your writing consultation session, please provide the information required below. (Items marked with a * are mandatory)



* Name



* E-mail Address



* P0#



* Local Address



* Phone number( for contact purposes)



* College



* Major



Status




Ethnicity



Native Language



Are you currently involved with any of these departments?		Disability Services UPAS Athletics Student Support Services



What special accommodations do you require due to disabilities? (If none, leave blank)