Student Information Form

Copy this form into your editor or email and complete, then email the completed form to me at jdresner@pittstate.edu

NAME:

CLASS/YEAR:

PHONE NUMBER:

E-MAIL ADDRESS:

(pittstate.edu address preferred, but only if you check regularly or it forwards to your preferred address)

MAJOR:

MINOR:

ADVISOR:

MAILING ADDRESS:

[above information required; questions below are optional but very useful to me]

WEB ADDRESS:

Previous classes related to history, Asia, or other relevant fields:

Language, travel or cross-cultural experiences:

Why are you taking this course? (Check all that apply)

___ Fulfills Major requirement

___ Fulfills Minor requirement

___ Considering change of major/minor

___ Fulfills Gen Ed requirement

___ Purely elective

___ Strongly suggested by advisor, parent, etc.

___ Fits my schedule

___ Looked interesting

___ Looked less boring than alternatives

___ Friend in class (___ now; ___ previously)

___ Relative in class (___ now; ___ previously)

___ Sounded easy

___ Needed a challenge

___ Heard good things about teacher

___ Heard good things about course

___ Specific interest(s): _______________ __________________________

___ Other: ________________________

Do you have any worries or concerns about this course?

Most active and/or meaningful extra-curricular activity(s) (clubs, work, children, etc…)? (Hours of non-academic work, per week: _____)

What other classes are you taking this semester?

Name of High School(s) Attended/Graduated (also colleges, if transfer/exchange student):

Academic and/or professional ambition:

Favorite quote, book, song or play?

Favorite cookie:

One comment to Student Information Form

  1. […] first homework assignment is to copy and fill out the Student Information Form and email it to me: jdresner@pittstate.edu (you can also use Angel, if you prefer). For full […]

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