Copy this form into your editor or email and complete, then email the completed form to me at firstname.lastname@example.org
(pittstate.edu address preferred, but only if you check regularly or it forwards to your preferred address)
[above information required; questions below are optional but very useful to me]
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?