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Salem State College
352 Lafayette Street
Salem, MA 01970
978-542-6000
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The School of Education
Instructional Computer Laboratory Reservation Form
Full Name:
Email:
Phone:
Class Info:
Course # or Program Name:
Section # (if applicable):
# of students or attemdees
Number of Days
to be Reserved: 		(eg. Once per week x 4 weeks = 4 days)
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