<font size=+2>Student Information Form<br><font>

<form name="studentid" action="/servlet/FormServlet" method=POST>

<input type=hidden name="E_Mail"  value="sauterv@msx.umsl.edu">

<input name="DOCsend" type="hidden" value="/tmp/doctosend">

<input name="URLreturn" type="hidden" value="/~sauter/ecommerce/info_submit.html">

<INPUT NAME="Return_type" TYPE="hidden" VALUE="lines">

<input name="SMTPreturn" type="hidden" value="/accounts/faculty/sauter/public_html/ecommerce/msis491.template">

<input name="from_address" type="hidden" value="msis491@msx.umsl.edu">


<INPUT TYPE="HIDDEN" NAME="dateandtime">
<INPUT TYPE="HIDDEN" NAME="class" VALUE="MSIS 491 - Winter, 2000">


	<p>

	<h5><font face="arial"><font size=+1>MSIS 491 -- Winter, 2000

	Section <INPUT NAME="section" TYPE="text" SELECT  VALUE="G-01" SIZE=4>
	<OPTION> </SELECT></font></CENTER></center><p>

	Name:  <INPUT NAME="Name" TYPE="TEXT" ROWS=1 SIZE="60" onblur="isValidName()"><p>
	Student ID Number:  <INPUT NAME="student_id" TYPE="text"><p>
	Home Telephone Number: <INPUT NAME="phone" TYPE="TEXT" ROWS=1 SIZE="14" onblur="isValidPhoneNumber()"><p>
	Work Telephone Number: <INPUT NAME="wphone" TYPE="TEXT" ROWS=1 SIZE="14" onblur="isValidwPhoneNumber()"><p>

<hr width=20%><p></center>

	Preferred E-Mail Address:
		<INPUT NAME="saddress" TYPE="TEXT" size="40" onblur="isEma()"> <p>

	Do you have a Web Home Page now?  <INPUT NAME="Web_Page" TYPE="RADIO" VALUE="no">No
		<INPUT NAME="page" TYPE="RADIO" VALUE="yes">Yes   <br>

	If yes, what is the URL?  
		http://<INPUT NAME="web_site" TYPE="TEXT" VALUE="www.umsl.edu/~" ROWS=1 COLS=10><p>

<hr width=20%><p>

	<dl>Program (please select all that are relevant):
		<dd><INPUT NAME="emph_area" TYPE="CHECKBOX" VALUE="MIS"  SELECTED>M.S. in MIS<br>
		<dd><INPUT NAME="emph_area" TYPE="CHECKBOX" VALUE="MISminor">MBA with MIS minor<br>
		<dd><INPUT NAME="emph_area" TYPE="CHECKBOX" VALUE="Accounting">M. Accounting<br>
		<dd><INPUT NAME="emph_area" TYPE="CHECKBOX" VALUE="MBA">MBA <br>

		<dd><INPUT NAME="emph_area" TYPE="CHECKBOX" VALUE="ecommFinance">E-Commerce Certificate<br>
		<dd><INPUT NAME="emph_area" TYPE="CHECKBOX" VALUE="Other">Other

	<i>please indicate your major</i>  <INPUT NAME="other_maj" TYPE="TEXT" VALUE="none" ROWS=1 COLS=30></dl><p>

	Hours to Graduation (not including this semester): <INPUT NAME="hours_left" TYPE="TEXT" VALUE="about 15" ROWS=1 SIZE="10"><p>

<hr width=20%><p>

	Current Occupation:<br> <TEXTAREA  NAME="occupation" VALUE="not currently employed" ROWS=2 COLS=60></TEXTAREA><p>

	Intended Occupation:<br> <TEXTAREA  NAME="intended" VALUE="I have no idea" ROWS=2 COLS=60></TEXTAREA><p>

<hr width=20%><p>

	Computer-Oriented Courses Taken (please list and indicate where and when you took them):<br> <TEXTAREA  NAME="comp_courses"  ROWS=5 COLS=60></TEXTAREA><p>

	Computer-Oriented Experience:<br> <TEXTAREA  NAME="comp_exper"  ROWS=5 COLS=60></TEXTAREA><p>

<hr width=20%><p>

	What do you hope to learn in this class? 
		<TEXTAREA  NAME="learn" ROWS=2 COLS=60></TEXTAREA><br><p>

	Describe your experiences in shopping via the Internet.  
		<TEXTAREA  NAME="shop" ROWS=2 COLS=60></TEXTAREA><br><p>

	How good are your skills in surfing the Web? 
		<TEXTAREA  NAME="surf" ROWS=2 COLS=60></TEXTAREA><br><p>

	How good are your skills in creating Web pages? 
		<TEXTAREA  NAME="create" ROWS=2 COLS=60></TEXTAREA><br><p>

<hr width=20%><p>

	Do you have any handicaps of which I should be aware? <INPUT NAME="handicaps" TYPE="TEXT"  VALUE="no"  ROWS=1><p>

	If yes, please specify:  <TEXTAREA  NAME="specific" ROWS=2 COLS=60></TEXTAREA><br><p>

	Other information of which I should be aware:<br>   <TEXTAREA  NAME="other" ROWS=5 COLS=60></TEXTAREA><p>

<hr width=20%><p>

	<INPUT NAME="submit" TYPE="submit" VALUE="Submit Form"><INPUT NAME="reset" TYPE="reset"><p>


</FORM>