PLAN 595

Initial Student Information

Would you please provide the following information:

Name, including what you like to be called

Home address and phone

Campus address and phone

Email address (please print clearly)

Present degree program and year

Present ideas for thesis or project research for your degree

Present ideas on first job upon graduation

Previous training, work or research experience relevant to course

Have you built a WWW page or used HTML?

Do you have a laptop with a wireless connection?

Do you have a web page or blog? If yes, please provide addresses if you are willing.