Personal Information - After submitting, you may wish to print the completed form for your records.

1. Name:

2. Current semester and year:

My phone number(s) 

3. I prefer to take my exams at . The hours there are
.

4. The calculator I will use is (list calculator make and model) .

5. The last math class I took and passed was  in the year .

6. I have read the Alternatives to College Algebra page and I believe that I need Math 1314 for my major which is

7. E-mail Address

8. What is the name, author and edition of the textbook/software for this course?

9. What is the deadline date for taking the last exam (and finishing this course)?

10. Any additional comments you might want to add

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Visit other ACC websites: ACC Home Page, Open Campus Home Page, or Math Dept Home Page

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02/12/06
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Send comments and questions to Juan Molina