Student Data Sheet

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                    NAME (Last, First)                                                                                STUDENT NUMBER

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ADDRESS

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TELEPHONE

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e-mail

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MAJOR

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DEGREE EXPECTED (TYPE AND AREA) (WHEN)

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OCCUPATION (CURRENT)

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(EXPECTED OR HOPED-FOR)

 

 PLEASE LIST ON THE REVERSE OTHER HISTORY COURSES TAKEN, ANY HISTORICAL INTERESTS OR HOBBIES, ETC. PLEASE EXPRESS WHAT YOU HOPE TO GET OUT OF THIS COURSE, AS WELL AS ANYTHING ELSE YOU WOULD LIKE US TO KNOW ABOUT YOU. ALL RESPONSES ARE STRICTLY VOLUNTARY AND WILL BE HELD IN CONFIDENCE.