Student Information Sheet

Class: CIS-165PH             Section # 45934              Spring 2006

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?

What score did you get on the Readiness Quiz? __________

What do you think you need to do, if anything, to get ready to take this course?

Do you feel that you have the necessary knowledge and skills to do well in this course?  Yes ___   No ___

Occasionally, the instructor is contacted about jobs for students. Do you want your name and email address given to such inquiries?

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.