1. Your Name: (write out phonetically if difficult to pronounce)
2. Address: Home
3. Campus
4. Telephone Numbers:

   Home	Campus
   Work	Fax

   E-mail address:
5. Total earned college credits:
6. Major:
7. Approximate grade point average:
8. Affiliation at Ramapo: AIS CA SABSSHS TAS Other (if checked, please see below:) I normally attend the following educational institution:
9. Occupation other than as a student?
10. Occupational goal?
11. Number of hours you work per week? (Excluding school work) Number of children
12. Special Ramapo programs:

    Teacher Certification

    Honors

    EOP

    Specialized Services

    Other

13. Would you like to serve on the following class committees?

    1. Awards Social

14. Previous courses in this subject area?

     

15. What are your computer and word processing skills? Describe your capabilities in detail.
16. What is your knowledge of the Internet? Desribe your capabilities in detail.
17. Most interesting individual (living or dead) in history?
18. Most influential individual (living or dead) in history?
19. Previous autobiographies? When? Where? Length?

20. How do you see this course helping you to achieve your goals?

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