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<HEAD>
<TITLE>Test Form</TITLE>
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<FORM name="course_approval_form" method="POST"
action="http://www.response-o-matic.com/cgi-bin/rom.pl" onsubmit="validate();">
<H1><CENTER> </CENTER></H1>
<H1><CENTER><FONT COLOR="#000000">B.Sc Course Approval Form</FONT>
</CENTER></H1>
<H3><CENTER>
<INPUT TYPE="hidden" NAME="your_email_address" VALUE="amiasof@30gigs.com">
<INPUT TYPE="hidden" NAME="your_name" VALUE="Webmaster">
<INPUT TYPE="hidden" NAME="email_subject_line" VALUE="B.Sc Course Approval">
<INPUT TYPE="hidden" NAME="required_fields" VALUE="your_email_address">
<INPUT TYPE="hidden" NAME="thank_you_title" VALUE="B.Sc">
<INPUT TYPE="hidden" NAME="return_link_url" VALUE="http://www.msn.com">
<INPUT TYPE="hidden" NAME="return_link_name" VALUE="Back To msn">
<INPUT TYPE="hidden" NAME="background_color" VALUE="#C0C0C0">
<INPUT TYPE="hidden" NAME="text_color" VALUE="#000000">
<INPUT TYPE="hidden" NAME="link_color" VALUE="#0000FF">
<INPUT TYPE="hidden" NAME="visited_link_color" VALUE="#8000FF">
<INPUT TYPE="hidden" NAME="active_link_color" VALUE="#0000FF">
</CENTER></H3>
<H3><CENTER>Test</CENTER></H3>
<P><CENTER>Just complete this form. Click on Submit when ready to
send.</CENTER></P>
<table align="center" width=650 border="0">
<tbody><tr>
<td>
<p><b>Please select any of the following exams you have passed.
If you have not passed any of these select the last line. <font color="red">(*required)</b></b></p>
</TD></TR></tbody></table>
<TABLE width=650 align=center border=3>
<TBODY>
<TR>
<TD>
<DIV><LABEL for=fill_in_text_chck1><INPUT id=fill_in_text_chck1 type=checkbox value=1
name=Type_Of_Exam_Student_passed> Advanced Placement (AP)</LABEL></DIV>
<DIV><LABEL for=fill_in_text_chck2><INPUT id=fill_in_text_chck2 type=checkbox value=2
name=Type_Of_Exam_Student_passed> International Baccalaureate (IB)
Diploma</LABEL></DIV>
<DIV><LABEL for=fill_in_text_chck3><INPUT id=fill_in_text_chck3 type=checkbox value=3
name=Type_Of_Exam_Student_passed>International Baccalaureate (IB)
Certificate</LABEL></DIV>
<DIV><LABEL for=fill_in_text_chck4><INPUT id=fill_in_text_chck4 type=checkbox value=4
name=Type_Of_Exam_Student_passed>Advanced (A) - Levels</LABEL></DIV>
<DIV><LABEL for=fill_in_text_chck5><INPUT id=fill_in_text_chck5 type=checkbox value=5
name=Type_Of_Exam_Student_passed>Advanced Subsidiary
(AS)-Levels</LABEL></DIV>
<DIV><LABEL for=fill_in_text_chck6><INPUT id=fill_in_text_chck6 type=checkbox value=6
name=Type_Of_Exam_Student_passed> Courses completed at a college and/or
another university</LABEL></DIV>
<DIV><LABEL for=fill_in_text_chck7><INPUT id=fill_in_text_chck7
onclick="if(checked) {
var e = document.getElementsByName('Type_Of_Exam_Student_passed');
for(var i=0;i<e.length-1;i++) e[i].checked = false;
document.getElementsByName('1st_Course_Written')[0].focus();}"
type=checkbox value=7 name=Type_Of_Exam_Student_passed>
I have not written and will not be writing any of the exams listed above</label></div>
</td></tr></tbody></table><br /><br />
<table align="center" width=650 border="0">
<tbody><tr>
<td>
<p>Please tell us which papers you have written or will be writing, and your grades if you know them.
If you do not know them, leave the spaces for the grades blank, and inform your adviser when you have the grades.
</p>
</td></tr></tbody></table>
<table align=center border="3">
<tbody><tr bgcolor="#87cefa">
<td valign="top">
Name of Paper/Course with Units/Modules </td>
<td valign="top"> Grade (if known) </td>
</tr>
<tr bgcolor="#87cefa">
<td valign="top"><INPUT TYPE="text" NAME="1st_Course_Written" VALUE="" SIZE=50 onkeypress="return noenter()"> </td>
<td valign="top"><INPUT TYPE="text" NAME="1st_Course_Grade" VALUE="" SIZE=20 onkeypress="return noenter()">
</td>
</tr>
<tr bgcolor="#87cefa">
<td valign="top"><INPUT TYPE="text" NAME="2nd_Course_ Written" VALUE="" SIZE=50 onkeypress="return noenter()">
</td>
<td valign="top"><INPUT TYPE="text" NAME="2nd_Course_Grade" VALUE="" SIZE=20 onkeypress="return noenter()">
</td></tr>
</tbody></table>
<br /><br />
<script type="text/javascript">
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for(var i=0;i<z.length-1;i++) {
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<H4> </H4>
<center>
<BLOCKQUOTE><P><INPUT TYPE="submit" NAME="Submit Form"
VALUE="Submit"><INPUT TYPE="reset" VALUE="Reset"></P>
</BLOCKQUOTE>
</center>
<P> </P>
</FORM>
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