Course:______________________________________________________________________

Semester/Year:________________________________________________________________

Name (Last, Preferred first):______________________________________________________

Class Standing (freshman, etc.):__________________________________________________

E-mail (optional):______________________________________________________________

Years of Spanish in primary/secondary school:_____________    How long ago?______________

Previous college Spanish (if any)___________________________________________________

Other contact with Spanish? ______________________________________________________

Other language study?__________________________________________________________

Other contact with other languages?_______________________________________________

* * *

The times that suit me best for my instructor to have a office hours are:

#1 ________

#2 ________

* * *

_____ I consent to my work being duplicated and kept by Dr. Mann and the NGCSU Department of Language and Literature for research and assessment purposes with my name intact.

_____ I consent to my work being duplicated and kept by Dr. Mann and the NGCSU Department of Language and Literature for research and assessment purposes with my name removed.

_____ I DO NOT consent to my work being duplicated and kept by Dr. Mann and the NGCSU Department of Language and Literature for assessment purposes.

* * *

I have read, understand, and agree to the conditions of the course syllabus and calendar.  I understand that due to the circumstances of the course, they may be changed in order to facilitate course delivery or administration, and that the instructor will make every effort to keep me apprised of any such changes.

Student signature: ________________________            Date: ______________________

HOME