Student Information

Name (print):   ______________________________________________________     Major: ________________

Day Phone:  ____________________    Evening Phone:  _____________________      e-mail:  _________________

Have a computer with Internet access?    yes___  no___

Prerequisite Check

1.  Have you achieved a qualifying score (shown in parentheses) on one of the following mathematics assessment tests?        yes__   no__
If so, write your score in the blank:

T-COM(39+)______              T-CPT(63+)_____                  T-ASSET(38+)____   

THEA(230+)______               SAT I(500+)_____                  ACT(19+)________

2.  Are you exempt from TSI requirements due to a prior college degree, TAAS test (score=86) or TAKS test (score=2200),
and also have received credit for second-year high-school algebra (Algebra II)?                                                            yes__   no__

3.  Have you met the TSI requirements (passed or exempt) and received college-level credit for a math course?                  yes__   no__       

4. Did you answer one of the above 3 questions with a “yes”?                                                                                             yes__   no__

Important: You must answer “yes” to question 4 in order to satisfy the prerequisite for this course.  According to ACC policy, students without the
prerequisite for a course are not permitted to enroll in it. 

If you are not sure about your answers to any of the above questions, please see me before end of class today.

Please note:  If the Pretest shows that your basic math skills need sharpening, I will recommend that you refresh them before embarking on
College Mathematics by first taking Elementary Algebra (MATD 0370).

Read and sign:
I have answered all questions truthfully, and have read the above advice.  I understand that my instructor may drop me from this course if I do not have the proper prerequisite background.  I understand that failure to give accurate information about prerequisites constitutes scholastic dishonesty. 

Signed: ___________________________________              Date: ___________________

Please ALSO complete the “Student’s Promise”