Name: (please print)

College and Class:

Nine digit number to post your grades under:

Email address:

Telephone:

Reason you are taking this class (it's OK to say it's a requirement):

 

 

 

Mailing address to send things to at the end of the semester:

 

 

 

Other science courses taken at college level:

 

 

 

 

Three important things about you: