Student Information Form
Name:
Student ID Number:
Status: Graduate Student Undergraduate Student
Home Telephone Number:
Work Telephone Number:
Preferred E-Mail Address:
Do you have a Web Home Page now? No
Yes
If yes, what is the URL?
http://
Program (select only one)
- B.S. in MIS
- B.S.B.A.
- MIS Minor (Undergraduate)
- M.S. in MIS
- MBA with MIS minor
- M. Accounting
- MBA
- Certificate Program Only
- Other
please indicate your major
If you are a graduate student, please state your undergraduate degree and institution:
Hours to Graduation (not including this semester):
Current Occupation:
Intended Occupation:
Computer-Oriented Courses Taken (please list and indicate where and when you took them):
Computer-Oriented Experience:
What do you hope to learn in this class?
How good are your skills in surfing the Web?
How good are your skills in creating Web pages?
Do you have any handicaps of which I should be aware?
If yes, please specify:
Other information of which I should be aware:
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