Name:   _________________________________________ (last, first)

ID:         ___________________________

Email:    ___________________________

Phone:  ___________________________

Prerequisite: CSE 310 Data Structures or equivalent

Satisfied:

Which University? _______________________________________

What semester?       _______________________________________

What course?            _______________________________________

If prerequisite was NOT satisfied as CSE 310 at ASU, you MUST submit appropriate documentation: including transcript
(record of grade) and supporting information.

By signing below, I am confirming the satisfaction of the prerequiste for this course as indicated above:

______________________________

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