Catalog Request

General Information
Full Name
Address
City,
State	Zip
Day Telephone	Evening Telephone
E-mail address
Education
College	Graduation Date
Degree	GPA
Other Education
Computer Skills/Information
I have working knowledge of computerized (check all that apply): Word Processors Spreadsheets Databases
Do you have access to a computer to do your homework? Yes No
Do you have access to the Internet? Yes No
Are you interested in our day or evening program? Day Evening Undecided
Demographic Information
We strive to reach people in a variety of professions and age groups. Please help us by providing the following optional information.
Gender
Age Choose Age Group 20-24 25-29 30-34 35-39 40-49 50+
Occupation
How did you first learn about MPI? Choose Yellow Pages Campus Newsletter Direct Mail Legal Community MPI Graduate T.V. Star Tribune Adult Ed. Ad MPLS/St Paul Magazine MPI Website
Other (please specify)
Please send me information regarding your program. Yes No
I CERTIFY THAT THE INFORMATION CONTAINED IN THIS APPLICATION IS ACCURATE AS TO THIS DATE. I UNDERSTAND THAT IF IT IS FOUND TO BE OTHERWISE, I MAY BE SUBJECT TO REJECTION OR DISMISSAL. Name Date
The Minnesota Paralegal Institute does not discriminate on the basis of race, color, national origin, sex, religion, age or disability in employment or the provision of services.