UNDERGRADUATE ADMISSION TERM CHANGE APPLICATION
Florida A&M University
Office of Admissions and Recruitment
1735 Wahnish Way
CASS Building • Suite 207
Tallahassee, Florida 32310
850.599.3796
http
://www.famu.edu
Excellence With Caring
Florida A&M University
Undergraduate Admission Term Change Application
ADMISSION APPLICATION PROCEDURES (Please read in full.)
This is the form you will use to apply for undergraduate admission to Florida A&M University. Florida A&M University encourages admission
applications from qualified students regardless of color, race, religion, national origin, gender, disability, veteran status, or marital status.
We encourage you to submit your application online. You may do so by visiting our website at www.famu.edu. Please be sure to type or print in
black ink and to complete each item, as incomplete forms cannot be processed.
1. Application for Admission
• Please attach your $15 cashier’s check or money order (U.S. currency: do not send cash or personal checks), made payable to Florida A&M
University. Your application will be returned if it is not included. This is a nonrefundable application fee.
• FAMU accepts ACT, SAT, or NACAC application fee waivers from First-time-in-college applicants ONLY.
•
Applications for admission will not be processed more than one year in advance of the date for which entrance is sought.
•
Answer all questions completely and accurately.
•
Priority deadline dates for admission are as follows.
Fall Term . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . May 1
st
Spring Term . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . November 1
st
Summer Term. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . March 1
st
•
Freshman applicants should submit two letters of recommendation from a high school teacher, counselor or principal.
2. Official Transcripts
Transcripts must be sent to the Office of Admissions and Recruitment at the following address.
Florida A&M University, Office of Admissions and Recruitment, 1735 Wahnish Way, CASS Building, Suite 207, Tallahassee, Florida 32310
Request that your current name and Social Security Number be added to the transcript if necessary. All transcripts and test scores become the sole
property of the university.
• If you are a beginning freshman or transfer applicant with less than 60 semester hours of transferable academic credit, ask your high school to
forward your official high school record.
• If you have attempted any coursework either as dual enrollment in high school or following high school, ask each school to forward an official
transcript of your academic record. Transcripts must be mailed directly from the institution or forwarded electronically.
• Completers of high school by GED must provide an official copy of test scores (as well as a partial high school transcript).
• Transfer students who completed two years of the same foreign language in high school must submit official high school transcripts.
3. Admission Test Scores
It is your responsibility to make the necessary arrangements to take the appropriate tests. Contact your school counseling office for more
information.
• ACT or Redesigned SAT with Writing included are required if you are seeking admission as a freshman or transfer with less than 30 semester
hours of transferable academic credit. Have the official test scores forwarded directly to Florida A&M University by the testing agency.
• Applicants whose native language is not English may be required to take the Test of English as a Foreign Language (TOEFL) and have their
scores submitted by the Educational Testing Service.
4. Additional Information: Admission Consideration Based on Disability
• If you wish to request special admission consideration based on a disability, FAMU will consider this information within the following guidelines: (1)
documentation regarding the disability will need to be provided on a voluntary basis, (2) all information will be kept confidential, (3) refusal to provide
information will not subject the applicant to adverse treatment, and (4) information will only be used in connection with the university’s voluntary
efforts to overcome the effects of conditions that may have resulted in limited participation of persons with disabilities. See item 12, page 1.
Applicants are not required to complete this item.
Below is a list of majors offered at Florida A&M University
BS Accounting
BS Actuarial Science
BS/BA African-American
Studies
BS Agriculture Science
BS Agricultural Business
BS Agronomy
BS Animal Science-Pre-
Veterinary
BS Animal Science-Industry
BS Architectural Studies
Architecture-1
st
Professional
BS Biochemistry
BS BioSys Engr-Bioproc &
Food Engr
BS BioSys Engr-Nat Res
ConserEngr
BS Biology
BS Biology Education
BS Biology Pre-Professional
BS Biomedical Engineering
BS Broadcast Journalism
BS Business Administration
BS Cardiopulmonary
Science
BS Chemical Engineering
BS Chemistry
BS Chemistry Education
BS Chemistry/Pre-
medicine/Pre-Dentistry
BS Civil Engineering
BS Computer Engineering
BS Computer Information
Systems
BS Computer Science
BS Construction
Engineering Technology
BCJ Criminal Justice
Criminal Justice ONLINE
BS/BA Economics
BS Electrical Engineering
BS Electronic Engineering
Technology
BA English
BS English Education
BS Environmental Sciences
BS/BA Environmental
Studies
BS Entomology & Strctl Pest
Control
BS Facilities Management
BS/BA Fine Arts
BS Food Science-Science
Technology
BS Food Science-Business
& Industry
BS/BA Global Security and
International Affairs
Global Security and
International Affairs ONLINE
BS Graphic Design
BS Health Care
Management
BS Health Information
Management
BS Health, Leisure, &
Fitness Studies
BS Health Science-General
BS Health Science-Pre-
Occupational Therapy
BS Health Science-Pre-
Physical Therapy
BS/BA History
BS History Education
BS Industrial Engineering
BS Information Technology
BS Magazine Production
BS Mathematical Science
BS Mathematics
BS Mathematics Education
BS Mechanical Engineering
BS Molecular Cellular
Biology
BS/BA Music/Choral, Voice
BS/BA Music/Instrumental
BS/BA Music Industry
BS Music Education/Choral
BS Music Education
/Instrumental
BS Newspaper Journalism
BSN Nursing
Nursing – RN-BSN
(Transfers Only) ONLINE
HAVE earned an Associate
of Science in Nursing
Degree. Must be a
Registered Nurse with
an unencumbered
license in the state where
they are working.
BS Organismal, Ecological
and Evr Biology
BS Pharmaceutical
Sciences
Pharmacy-Undergraduate
Pharmacy-Professional
BS/BA Philosophy
BS/BA Philosophy &
Religion
BS Physical Education
BS Physics
BS Physics Education
BS/BA Political Science
BS/BA Public Administration
BS Political Science
Education
BS Pre-Kindergarten-
Elementary Education
BS Pre-Kindergarten-
Primary Education
BS Pre-Medicine
BS/BA Psychology
Psychology ONLINE
BS Public Relations
BS/BA Religious Studies
BSW Social Work
BS/BA Sociology
Sociology ONLINE
BS Supply Chain
BS/BA Theatre
BS Veterinary Technology
Type or Print in Black
Ink
1. / /
U. S. Social Security Number FAMU Student ID Number
Last Name First Name Middle Name Jr., III, etc.
2. For which term, in which year, do you seek
admission?
August
January
May
June
3. This
application
is for
enrollment as:
First time in college freshman
Transfer
-freshman
Transfer
-sophomore
Transfer
-junior
Transfer
-senior
Second
bachelor’s
degree
4. If your transcripts, test scores, etc. might arrive under any names(s) other than those listed
above, enter here:
5.
a.
Nation
of
Citizenship:
b. Country of B
irth:
6.
Date
of
Birth:
/
/
7. Type your
permanent address.
All
correspondence
will
be mailed to this
address.
Street Address Apt.
No
City County (or Province)
State/Nation
( )
Zip
Code H ome
Telephone Number
( ) ( )
Mobile
Telephone
Number Fax
Number
Email Address (required)
8. Male
Female
9.
Race/National
origin
(please check only on e):
American Indian or Native
Alaskan Asian
Asian or Pacific Islander
Black or African
American
White (not of Hispanic origin)
If Hispanic or Latino, select
ethnic group:
Hispanic
Hispanic/Latino
(Florida A&M University is a recipient of federal dollars and is
required by the federal government to solicit certain
demographic information to meet federal reporting
requirements. Applicants are requested to provide this
information voluntarily. This information will not be utilized in
a discriminatory manner.)
10. In Case of an emergency, indicate the person you request the university contact:
Last Name First Name M.I.
Street Address Apt.
No
City
State/Nation
Zip
Code
( ) ( )
Home
Telephone
Number Mobile
Telephone
Number
Relationship:
Father
Mother
Legal Guardian
Other:
Parent’s Email Address (if available)
11. What is your planned primary
major?
Bachelors of Science Degree Program
or
Bachelor of Arts Degree Program
What is your planned secondary
major?
Bachelors of Science Degree Program
or
Bachelor of Arts Degree Program
13. High School
Graduation
Date: /
Month
Year High School Name (Official
transcript
must be
provided)
High School Code:
(Ask your counselor for the 6-digit CEEB Number) City State/Nation
If
High School was
completed
by GED, enter
year
(Official copy of test scores and partial high school transcript required)
An official transcript from each postsecondary school, college, or university you have
attended (including dual enrollment and transit course work) must be provided to
Florida A&M University. Please list in
chronological
order every
postsecondary
institution
(including dual enrollment and transit course work) you have
attended
or
will
attend
prior
to
entering this university. (You must include schools even if you
did
not
complete a term.) Include Florida A&M University if you
attended
pre
viously. For
multi-campus
institutions, indicate the specific
campus.
Failure to
list all institutions could result in your application
being
denied or your
admission being rescinded. Use a
separate
sheet if
necessary.
School (Please do not abbreviate) City, State or
Nation
Enter dates of
attendance
(including
present
enrollment)
and
degrees
earned
or
expected before
attending
this
university.
Include
Associate
Degrees,
certificates,
or
diplomas
Enter credit earned or
expected from each
institution attended.
Dates of
Attendance
Degree
Date
Credit Hours
From
To
Earned
Expected
Earned
Expected
Mo. Yr. Mo. Yr.
T
y
p
eMo. Yr.
Num
b
e
r
Unit
Sem./Qtr.
Page 1
Failure to
answer
these
questions
will delay
processing
of your
appl
i
cat
i
on.
15.
If
your answer to any of the following is yes, you must submit a full
statement
of relevant facts on a
separate
sheet
attached
to
this
form.
You may be
required
to furnish the university with copies of all official
documentation explaining
the final
disposition
of
the proceedings.
a. Yes No Are you currently or have you ever
been, charged
with or subject to disciplinary action for
scholastic
or any other
type
of
misconduct
at any
educational institution?
b. Yes No Have you ever been
charged
with a violation of the law which
resulted
in, or, if still
pending,
could result in,
probation,
community
service, a jail
sentence,
the
revocation
or
suspension
of your driver’s license (including traffic
violations
which
resulted
in a fine of $200 or
more)?
If your records have been
expunged
pursuant to
applicable
law, you are not required to answer yes to these
questions.
If you
are
unsure
whether you should answer yes to 15a or 15b, we strongly
suggest
that you answer yes and fully disclose all
incidents.
By
doing
so, you can
avoid any risk of disciplinary action or
revocation
of an offer of
admission.
16. If you have taken or plan to take any of the tests below, enter the month and year.
Official records of all test scores must be provided directly from the testing agency.
17. Have you
completed
2 years of
the same
foreign language?
Yes
No
If yes, where?
High School
College
If yes, please submit appropriate official
transcripts.
1
st
Time 2
nd
Time 3
rd
Time 4
th
Time 5
th
Time
Test Mo. Yr. Mo. Yr. Mo. Yr. Mo. Yr. Mo. Yr.
ACT
SAT
TOEFL
18. Present High
School/College Enrollment
a.
If
you are currently enrolled in a high school, college, or university, list all high school and college level courses which you are
now
taking or
expect
to
complete before entering
Florida A&M University. Use a
separate
sheet if
necessary.
b.
If
you are not currently enrolled and do not
expect
to
complete
any courses, check
here.
Courses for Which You Are Now
Enrolled
Courses You Expect to Complete Before
Entering
Name
of
Institution:
Name
of
Institution:
Title of
Course
Course
No.
Date
Course
Credit Hrs.
(Sem./Qtr.
Title of
Course
Course
No.
Date
Course
Credit Hrs.
(Sem./Qtr.
Mo. Yrs
Mo. Yr.
19. For Non-U.S. Citizens
Only:
City and Country of
Birth
What
VISA
do you presently hold? F1 F2 J1 J2
None
Other: I-94 Expiration Date:
/
What
VISA
are you applying for: F1 F2 J1 J2
None
Other: Mo. Yr.
What
institution
issued your last I-20? Did you
attend?
Yes
No
If
a
permanent immigrant,
enter the alien
registration
number shown on your I-551 form: or you must provide
a
photocopy
of your Alien
Registration card.
20. If your native language is other than English, how many years have you studied and spoken English?
Language: Years Spoken:
Language: Years Spoken:
21. Important. You must read and sign the following section in order to complete your application to this university.
I understand that this application is for admission and is valid only for the term indicated in item 2 on page 1. I also understand and agree that I will be
bound by the university’s regulations concerning application deadline dates and admission requirements. I further agree to the release of any transcript,
student record, and test scores to this institution (including any ACT and Redesigned SAT score reports that this institution may request from the College
Board or ACT).
I certify that the information given in this application is complete and accurate, and I understand that to make false or fraudulent statements within
this application or residence statement may result in disciplinary action, denial of admission and invalidation of credits or degrees earned. If
admitted, I hereby agree to abide by the policies of the Board of Governors and the rules and regulations of Florida A&M University. Should any of the
information I have given change prior to my enrollment, I shall immediately notify the Office of Admissions and Recruitment.
I understand that the $15 cashier's check or money order I submit with this application is a nonrefundable fee.
Applicant’s Signature (please type) U.S. Social Security Number Date
Page 2
Information for Residency Classification
A Florida “resident for tuition purposes” is a person who has, or a dependent person whose parent or legal guardian has, established and maintained legal
residency in Florida for at least (12) consecutive months preceding the first day of classes of the term for which Florida residency is sought. Residence in Florida
must be as a bona fide domicile rather than for the purpose of maintaining a residence incident to enrollment at an institution of higher education. To qualify as a
Florida resident for tuition purposes, you must be a U.S. citizen, a foreign national in a nonimmigrant visa classification that grants you the legal ability to establish
a bona fide domicile in the United States, a permanent resident alien, or legal alien granted indefinite stay by the U.S. Citizenship and Immigration Services.
Other persons not meeting the twelve-month legal residence requirements may be classified as Florida residents for tuition purposes only if they fall within one of
the limited special categories authorized by the Florida Legislature pursuant to section 1009.21, Florida Statutes. All other persons are ineligible for classification
as a Florida “resident for tuition purposes.” Living in or attending school in Florida will not, in itself, establish legal residence. Students who depend upon out-of-
state parents for support are presumed to be legal residents of the same state as their parents. Residency for tuition purposes requires the establishment of legal
ties to the state of Florida. Students must verify that they have broken ties to other states if the student or, in the case for dependent students, his or her parent
has moved from another state.
PLEASE TYPE OR PRINT if submitting hard copy.
Name of Student: ____________________________________ Social Security #: ____________________
Student is a:
U.S. Citizen
Non-U.S. Citizen
Permanent Resident
Other
Date of Birth: ____________________
Alien Registration Number: _____________________________ Issue Date: _________________________
All non-U.S. citizen students are required to submit documentation of their legal status in the United States as issued by the United States Citizenship
and Immigration Services office.
NON-FLORIDA RESIDENT
I do not qualify as a Florida resident for tuition purposes for the term for which this application is submitted. I understand that should I qualify for a future term, it will be
necessary for me to submit an updated Residency Declaration while providing prescribed, supporting documentation to substantiate as “reclassification” of my status.
Submission of this required document must occur prior to the beginning of the term for which residency is sought. I do not have to complete any further portion of this form
except for the signing below.
Student Name: ______________________________________________________________ Social Security #: _______________________
Signature of Student: (Electronic or ink):___________________________________________ Date: _________________________________
TO BE COMPLETED BY THE STUDENT SEEKING FLORIDA RESIDENCY FOR TUITION PURPOSES:
I qualify as a resident for tuition purposes, as defined by s. 1009.21, Florida Statutes, for the term for which this application is submitted. I understand that it will
be necessary for me to provide copies of the required documentation upon admission, in order to be considered as a Florida resident for tuition purposes. I have
read the residency information on qualifying as a dependent or independent student, and declare that: (select one of the options below):
I am a dependent student, as defined by s. 1009.21(1)(a), Florida Statutes, in that I am eligible to be claimed as a dependent under the federal
income tax code by the claimant below. The claimant is my “parent” as defined by s. 1009.21(1)(f), Florida Statutes, (i.e., either or both parents of the
student, any guardian of a student, or any person in a parental relationship to the student). My parent has maintained legal residence in Florida for at least
the past 12 consecutive months. As defined by section 1009.21(1)(d), Florida Statutes, “’legal resident’ or ‘resident’ means a person who has maintained
his or her residence in this state for the preceding year, has purchased a home which is occupied by him or her as his or her residence, or has established
a domicile in this state pursuant to s. 222.17.” A copy of your parent’s tax return may be requested to establish dependence.
I am a dependent student who has resided with an legal guardian or adult relative other than my parent, and my legal guardian or adult relative has maintained
legal residence in Florida for at least the past 12 consecutive months. (Proof of Guardianship (required if claimant is NOT the student's parent: Documents showing
Court appointed guardianship (power of attorney is NOT sufficient) or Five consecutive years of tax returns in which the student is claimed as a dependent by the
claimant.)
I am an independent person who has maintained legal residence in Florida for at least the past 12 consecutive months. I provide 51% or more of my own
support. An independent student generally includes a person who is at least 24 years old, married, a graduate or professional student, a veteran, a member of
the armed forces, a ward of the court, or someone with legal dependents other than a spouse, pursuant to the United States Department of Education for the
purposes of federal financial aid eligibility. There may be limited cases where a person under the age of 24 years old may qualify as an independent student.
Such students will be required to verify independence (including financial independence.) A copy your tax return may be requested to establish independence.
QUALIFICATION BY EXCEPTION (to be completed by the student)
As provided in s. 1009.21, Florida Statutes, I qualify for residency based on the following permitted exception (documentation required):
A. I am a qualified beneficiary under the terms of the Florida Prepaid College Program (s. 1009.98, Florida Statutes.) (Required: Copy of Florida Prepaid
Recipient card.)
B. I am married to a person who has maintained legal residence in Florida for at least the past 12 consecutive months. I now have established legal
residence
and intend to make Florida my permanent home. (Required: copy of marriage certificate and/or other documents required to establish residency.)
C. I was previously enrolled at a Florida state postsecondary institution and classified as a Florida resident for tuition purposes. I am transferring
to another Florida state postsecondary institution within 12 months of the previous enrollment.
D. I was previously enrolled at a Florida state postsecondary institution and classified as a Florida resident for tuition purposes. I abandoned my
Florida domicile less than 12 months ago and am now re-establishing Florida legal residence.
E. Active duty members of the Armed Services of the United States residing in this state and their spouses and dependent children, and active drilling
members of the Florida National Guard. (Required: Copy of military orders or DD2058 showing home of record.)
F. Active duty members of the Armed Services of the United States and their spouses and dependents attending a Florida College System
institution or state university within 50 miles of the military establishment where they are stationed, if such military establishment is within a county
contiguous to Florida. (Required: Copy of military orders.)
G. United States citizens living on the Isthmus of Panama, who have completed 12 consecutive months of college work at the Florida State University
Panama Canal Branch, and their spouses and dependent children. (Required: Copy of marriage certificate or proof of dependency.)
H. Full-time instructional and administrative personnel employed by state public schools and institutions of higher education and their spouses and
dependent children.
I. Students from Latin America and the Caribbean who receive scholarships from the federal or state government. Any student classified pursuant to this
paragraph shall attend, on a full-time basis, a Florida institution of higher education. (Required: proof of scholarship and Latin America or Caribbean
residency.)
Page 3
J. Southern Regional Education Board’s Academic Common Market graduate students attending Florida’s state universities. (Required: Certification
letter from State Academic Common Market Coordinator.)
K. Full-time employees of state agencies or political subdivisions of the state when the student fees are paid by the state agency or political
subdivision for the purpose of job-related law enforcement or corrections training.
L. McKnight Doctoral Fellows and Finalists who are United States citizens. (Required: Verification from graduate studies.)
M. United States citizens living outside the United States who are teaching at a Department of Defense Dependent School or in an American International
School and who enroll in a graduate level education program which leads to a Florida teaching certificate.
N. Active duty members of the Canadian military residing or stationed in this state under the North American Air Defense (NORAD) agreement, and their
spouses and dependent children, attending a Florida College System institution or state university within 50 miles of the military establishment where they
are stationed. (Required: proof of active duty membership for specified purpose.)
O. Active duty members of a foreign nation’s military who are serving as liaison officers and are residing or stationed in this state, and their
spouses and dependent children, attending a Florida College System or state university within 50 miles of the military establishment where the foreign
liaison officer is stationed. (Required: proof of active duty membership for specified purpose.)
TO BE COMPLETED BY THE CLAIMANT/PERSON CLAIMING FL RESIDENCY:
NOTE: If the student is a dependent, the parent is the claimant and will complete this section and provide supporting documentation. If the student is
independent, the student is the claimant and will complete this section and provide supporting documentation. No single document shall be conclusive in
establishing residency. Additional documentation, other than what is prescribed, may be requested in some cases. All documentation provided is subject to
verification. Evidence of ties to another state may result in denial of Florida residency for tuition purposes.
Claimant/Name of Person Claiming FL Residency: _________________________________________________________
Claimant’s Relationship to Student: _____________________________________________________________________
Claimant’s Address: _________________________________________________________________________________
Telephone Number: _________________________________
Date Claimant began establishing legal FL residence: _____/_____/_____
Alien Registration Number: _____________________________ Issue Date: _____/_____/_____
All non-U.S. citizen are required to submit documentation of their legal status in the United States as issued by the United States Citizenship and
Immigration Services office.
PROVISION OF DOCUMENTS TO SUPPORT CLAIM OF FLORIDA RESIDENCY
Per s. 1009.21(3)(c), Florida Statutes, the residency determination must be documented by the submission of written or electronic verification that includes two or
more of the documents identified below. No single piece of evidence shall be conclusive.
A. Claimant must provide at least one of the following of his/her personal documentation:
Florida voter's registration card Number:______________________ Registration Date:_____/_____/_____
Florida driver's license. Number:____________________________ Original Issue Date:______/______/______ Current Issue Date: ____/_____/_____
State of Florida identification card. Number:___________________ Original Issue Date:______/______/______ Current Issue Date: ____/_____/_____
Florida vehicle registration. Number:_______________ Original Issue Date:______/______/_______ Current Issue Date: ______/_______/_______
Proof of permanent home in Florida occupied as primary residence for 12 consecutive months prior to the student’s enrollment. (Required: document such as
a deed or other evidence of title to property used as primary residence, a homeowner’s policy, a title insurance policy, evidence of a property tax payment on
the primary residence, or a lease of multiple years’ duration.)
Proof of a homestead exemption in Florida. (Required: document from the county tax collector demonstrating the application of a homestead exemption
to the claimant’s primary residence.)
Official transcripts from a Florida high school for multiple years (2 or more years), if the Florida high school diploma or GED® was earned within the last 12
months.
Dates of Attendance:_____________________ Graduation Date: ______/______/_______). (Required: transcript)
Proof of permanent full-time employment in Florida for at least 30 hours per week for a 12-month period. (Required: pay stubs or W-2 form for past 12
consecutive months)
B. Claimant may provide one or more documents from the following categories to demonstrate residency in Florida
(to be used in conjunction with one document from above):
Declaration of domicile in Florida
Florida professional or occupational license
Florida incorporation
Document evidencing family ties in Florida
Proof of membership in a Florida-based charitable or professional organization
Any other documentation that supports your request for resident status, including, but not limited to, utility bills (required: proof of 12 consecutive months of
payments); a lease agreement (required: proof of 12 consecutive months of payments); or an official state, federal, or court document evidencing legal ties to
Florida.
RESIDENCY DECLARATION:
I, the undersigned, hereby declare that I have read the foregoing document and that the facts stated in it are true and further affirm the authenticity of the
information provided on all pages of this Residency Declaration. I understand that any false or misleading information on this Residency Declaration, or provided
in support of this Residency Declaration, will subject me to penalties pursuant to section 837.06, Florida Statutes, for making a false statement. I give permission
for the institution to review or examine any and all documents and records, including those accessible electronically, which may assist in support of my status as a
Florida resident for tuition purposes.
Student Name (Please Print): _____________________________________________________________
Claimant Name (if not the Student):_________________________________________________________
Signature of Claimant (Electronic or ink): _____________________________________________________ Date: ____________________________
Page 4
