Classical Music
in the United States


REGISTRATION FORM
This form provides me with information to help me develop the course and address your individual educational needs. Your contact information will be added to the class roster, but all other information will remain private. Please submit this form prior to the third class. Thanks.

Subject:

Email Address :

Name :

Student ID#
Are you registered for MHM408/508? Yes No Wait-listed
Local Daytime Phone
How many times per day do you check your email?

School/Local/Campus address

Permanent/Summer/home address (if different)

School or College

Year (click here to select)

Counselor name
Counselor's phone number (if known)

Major
Career Goals

How did you find out about this class?

Reason(s) for taking this class:

What do you hope to learn in this class?

What skills, contacts, information, or other resources can you offer the class?


Do you play an instrument or sing?
Are you interested in performing in a class recital?
Yes
No

What other kinds or music history courses have you taken?

Can you write HTML code for a Web site and post it to the server?
Yes
Yes, but "with a little help from my friends"
No

Group Work

How would you describe your work with project groups and collaborative learning in the past?

(click here to select)

Comments about group work / collaborative learning?

Miscellaneous

Your favorite music styles and bands

Your least favorite music and bands

Interests (music [styles] plus others)

Please characterize your motivation level for this class:
What grade do you expect to receive in this class?
A B C D
plus (+) none minus (-)

Optional Questions for class demographics:

Gender: female male Age: GPA:
Race:
Ethnicity (family origins):

to send entries to professor

to clear form and start over



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