General Information

First Name:		Last Name:
I prefer to be called:		Student ID:
Grade Posting Name:		Phone #:
Web Address, if any:		E-mail:
College Year:	Freshman Sophomore Junior Senior Super Senior Graduate	Current GPA:
Expected Graduation Date:
Course Being Taken:	Management Information Systems (MIS) Production & Operations Management (POM) E-Commerce Advanced E-Commerce Analysis and Design I Analysis and Design II Business Computer Apps. Hardware & Op. Systems

Class Related Information

1. Do you mind being called upon in class?:	Yes No Indifferent
2. Why are you taking this course?	Major Minor Other

3. I believe that I am in the Top 10% Top 25% Top 50% Bottom 50% Bottom 25% Bottom 10% of all the students in my major at this college.

4. Is there anyone in class that you would prefer not to work with?:

5. Do you have any learning disabilities or special needs of which I should be aware of?:

Yes No

5(a).If yes, what?:

6. What do you hope to get out of this class?:

7.Comments concerning issues I ought to be aware of...:

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Disclaimer: All information submitted to me will be used against you during class!!

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