All of the information in this form is for professor/department use only.

Student Information Form

Last Name: First Name:

Student ID (if known):

Course: Select COSC 1315 COSC 1320 ITSE 1411 ITSE 1331 ITSE 2305 ITSE 2349 ITSE 2402

Telephone Numbers (not necessary but can be helpful if/when quick contact is required):
Home:
Work:
Other:

ACC E-mail Address:

Issues of which the professor should be aware:

Reasons for taking this course:
Personal Interest
Required by degree, my degree program is
Work Related, Please explain in comments section
Recommended by:
Other Please explain in comments section

Please indicate the following:
Hours working per week
Number of credit hours enrolled in this semester
Number of computer courses taken at ACC
Highest Degree Earned

What computer courses have you already completed?


What computer related work experience do you have?


Comments:

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