STUDENT INFORMATION SHEET

(Fill out both pages, please)

Name/Nickname or Preferred (FULL) Name ________________________________________

Do you live:
in your own home?_____ at home with parents? ____ in off-campus apartments?
____

What is your GEOGRAPHIC location (city) while taking online classes?

_______________________

What is your Major ___________________________________________________

How many classes are you taking this semester _____________________________

Do you work? Y____ N____ # of hours per week __________________________

If you work, where do you work? ________________________________________

What is your FUTURE dream job? ________________________________________

Are you a member of the U.S. or state military services or a veteran? Y____ N____

Are you a first-generation college student? Y____ N____

What would you like me to know about you as we get ready to spend 15 weeks together? -
___________________________________________________________________
___________________________________________________________________

What experience have you had giving presentations and/or with public speaking? PLEASE CIRCLE!
None Some experience in school or at work (Circle which) A lot of experience in school
or at work (Circle which)

Do you read a daily newspaper (either online or actual paper)? YES NO

Which of the following web sites do you frequently access?

 YouTube
 Facebook
 Google Plus
 Twitter
 Skype
 Instagram
 Pinterest
 LinkedIn
 Others???
_____________________________________________________________________

Since we will discuss MUSIC as an important form of human communication, please answer
the following questions about your musical tastes:

My favorite kind(s) of music (Circle one or more): COUNTRY, RAP, HEAVY METAL,

CHRISTIAN, OLDIES, R & B, SALSA, URBAN, ETHNIC, HIP-HOP, GENERAL

POP, OTHER?____________________________________________________________

THE SOUNDTRACK OF YOUR LIFE

If you had to choose one SONG/ARTIST that best describe your life to date, what would it be?
(Do not type URL!)
_____________________________________________________________________________

_____________________________________________________________________________

(Please put some thought into the above question, since I will not play your song if it contains
offensive language. Don’t suggest any song that might be embarrassing to anyone
(including your mother) if we play it in our class.)

__________________________________________________________________