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To: Course Number _________________
Seminar Number _________________
Date of Seminar _________________


In keeping with the principals of the Stanford Honor Code*, the undersigned certifies attendance at the above seminar which was presented at Stanford on the date indicated.


___________________________________________________
Signature

___________________________________________________
Printed Name

___________________________________________________
Organization

___________________________________________________
Date Signed


* "By their registration at the University, all students affirm that they will not give or receive aid on examinations; that they will not receive unpermitted aid in class work, in the preparation of reports, or in any other work that is to be used by the instructor as the basis of grading."

Submit with Route Form to:

Stanford Center for Professional Development
496 Lomita Mall, 401 Durand Building, Stanford, CA 94305-4036

650-725-3015 Fax: 650-736-1266
e-mail: scpd-distribution@lists.stanford.edu


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