Georgia State University
Friday, November 20, 2009 



You have requested to enroll in the following event:
Title PMBA/MHA Information Session
Date/Time Tuesday, November 17, 2009
12:00 PM - 1:00 PM
City/Metro Area Peachtree-Dunwoody
Location 5909 Peachtree-Dunwoody Road NE
Building 5909, Suite 100
Atlanta GA 30328
United States
To enroll, please complete the form below. (*Required)
*First Name
Middle Name
*Last Name
*Gender
*Street 1
Street 2
*City
State
State/Province if OTHER
*Zip/Postal Code
Country
*Phone Number
(Do not include dashes or spaces)
Fax Number
(Do not include dashes or spaces)
*Email
*How did you first hear about this event?
If necessary, please specify
*Undergraduate Institution
*Current Employer
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