Please fill out and hand in on first day of class

NAME: _________________________________________________________________

MAJOR/INSTITUTION:___________________________________________________

YEAR: (Fr, So, Jr, Sr, unclassified, special) ____________________________________

ADDRESS (where you live this summer): _____________________________________

_______________________________________________________________________

CELL PHONE NUMBER: _________________________________________________

PERMANENT EMAIL ADDRESS: __________________________________________

UNCA EMAIL ADDRESS: ________________________________________________

CURRENT OR LAST MATH COURSE: _____________________________________

REASON(S) FOR TAKING THIS COURSE___________________________________

OTHER COURSES YOU ARE TAKING THIS SUMMER ________________________

HOURS OF WORK OFF CAMPUS THIS SUMMER ____________________________

WHAT COURSE GRADE DO YOU NEED TO EARN THIS SUMMER? ____________