STUDENT INFORMATION FORM


Students in all of my classes should fill out this form during the first week of the semester. (If I already know you and had you in class during a past semester, I'd still like you to resubmit your basic contact info. so that I know I have your most recent info. - it will help keep me organized! Thanks!!!)

I like to know everyone's names as soon as possible. If you have a photo of yourself that you could upload here, it would be extremely helpful for me in putting your name with your face!
First Name (required) *
Last Name (required) *
If you have a nickname you want to be called, let me know here
If you have a commonly mispronounced name, please give me a pronunciation guide here so I don't butcher it all semester!
E-mail Address: *
Any other alternate email addresses that you use?
Phone number(s) you can be reached at this semester. Please indicate whether it's your dorm phone, cell phone, etc. (required) *
Who is your academic advisor? (required) *
Which class(es) are you taking WITH ME this semester? (required) *
What is your class year? (required) *
Do you live on or off campus? (required) *
Last 4 digits of your Social Security # - this will be used when I create a password for you to check your grades on Gradenetwork.com (if you are an international student and do not have a social security number yet, you can just make up a 4 digit number to serve as your password) *
What is your major (or what are you thinking of majoring in)?
What is your hometown?
Career Experience and/or Aspirations (if any yet!)
Media Interests (favorite TV shows, movies, websites, magazines, etc.)?
How would your friends describe you?
I've outlined in my syllabus what I expect of you as a student...now let me ask you, what are YOUR expectations of this class and of me as an instructor?
Are there any areas you feel particularly weak in (ie. writing, speaking in front of a group, speaking up in class, etc.?) If so, what can I (and you!) do to help you overcome these weaknesses?
What are your strengths?
Anything else I should know about you? Concerns? Likes? Dislikes? Any learning disabilities I need to know about? Any conditions you have or medications you are on that I should know about? Anything else I haven't covered that is important for me to know about you?

* Required


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