INLS 210-36: USER EDUCATION

If you are registered for INLS 210-36 in the summer semester, please enter the information requested below. I will use it to prepare a class list with some of the information that you provide. If you prefer not to have your address and phone number listed, please check this box and only your name and some background information will be provided. If you have questions, please email me at Evelyn Daniel .

Hit the Send key at the bottom of the page when you have finished entering. If you wish to start over, hit RESTART.

Name:

First Name:
Nickname:
Last Name:

Address:

Email Address:
Street Address:
City/Town:		State:

Telephone:
(Day): (Night):

Work:
Place of Work (if any):
Nature of Work (What do you do?):
Prior Experience relevant to this course:

Education:
I am a 1st yr 2nd yr special student. I am in the MSLS MSIS other program.

Prior Education (Degrees - subject and school):

Future Plans:
Career Aspirations (type of work and kind of organization):

Prior Teaching Experience:
Have you had any teaching experience? If so, please describe below.
What is one interesting fact about you that you would be willing to share with the rest of the class? (e.g., a hobby, an experience, an aspiration, a quality, a pet, etc.):

Thank you for providing this information.

Revised 7/19/98