Student Information Sheet

Class: CIS 164           Section # 27818               Spring 2003

Name:_____________________________________________________________

Contact Information:

Email:_______________________________________________________

Phone number:________________________________________________

Grading Option (circle one): Letter grade or Credit/No-Credit

Do you have any physical or learning disabilities that I should be aware of?


What do you hope to gain from taking this course?


Cabrillo offers computers and other equipment for student use in the CTC and other labs. Where do you plan to work on homework assignments?

  1. At Cabrillo
  2. Off-campus
  3. Both

What are your educational goals at Cabrillo? (circle all that apply)

  1. AA
  2. AS
  3. Transfer
  4. Certificate
  5. Career Advancement
  6. Personal Enrichment
  7. Other:

How many CIS courses are you currently taking:   1   2   3   4   5  more

Which educational track are you pursuing? (circle all that apply)

  1. Computer Science
  2. CCNA & CCNP (Networking)
  3. Database Administration
  4. MCSA - Microsoft Certified Systems Administrator
  5. Linux SAIR (Vendor Independent Linux Certification)
  6. Web Programming
  7. Other:

What are your preferred class times? (circle all that apply)

  1. Early morning (8-10 AM)
  2. Late morning (10 AM-12 PM)
  3. Early afternoon (1-3 PM)
  4. Later afternoon (3-5 PM)
  5. Evenings
  6. Weekends
  7. Distance Learning
  8. No preference

Which of the following courses would you likely to take if offered? (circle all that apply)

  1. Computer Security
  2. C# Programming
  3. Enterprise (Advanced) Java
  4. Advanced SQL programming
  5. Oracle 9i Database Administration and PL/SQL Usage
  6. Programming Database-Driven Web Sites With PHP
  7. Programming Database-Driven Web Sites With ASP.NET
  8. UNIX Device Drivers
  9. Suggestions:

Please attach a photo, drawing or other likeness to this sheet. Alternatively, please describe yourself so the instructor can identify you easily (e.g. "I'm the one with purple hair"). Do not attach a copy of your driver's license or any other document containing private information.