Sample Registration Form (Purdue University)
Last Name: ________________ First Name: ________________
Hometown (State): _____
Local Telephone: __________________ GPA: _____
E-mail Address: ________________________
Semester Standing: ___________________ Major: ___________
Other related courses completed:
How would you rate your computer skills on a scale of 1 to 5 with 5 meaning that you can do most anything you want on a computer:
1 2 3 4 5
Do you work part time? Hours per week: ____________
Extra-curricular activities? Hours per week: ___________
Why did you decide to take this course?
What do you expect to learn from it?
What do you want to be when you grow up?
What are the most important things I need to know about you as student and colleague?
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