Name:________________________________________________________________________
Degree that you are working toward:
BS MS PhD Major: ____________ Expected
graduation date(month/year): ___________
Prerequisites:
Email address or telephone no. where you can be reached:_______________________________
Why are you enrolled in this course:
What do you expect to learn from this course:
What are your education goals beyond the current degree you are working toward:
What are your career objectives as far as you know right now:
Any other comments you would like to make (about anything!):