Math ______ Information Sheet Section Number _____

Name: ______________________________________ ID: _______________

(print)
Email Address: _______________________________________ (This is the
one to which I will send correspondence, so make sure you read this one.)

Print and complete this form in your own handwriting.

(Typed responses will receive the grade of 0.)

Success in this online course depends on you!

To do well in this class, you must be willing to put in time and to work. It is not a
self-paced class, although there are no set times each day that you must login
or work. There are firm due dates by which assignments and exams must be
completed. No exceptions are made to due dates; late work is not accepted.
Work is always accepted early though!

Please understand that you are responsible for reading all information about the
course that I have provided in ecampus, in emails, in the syllabus, and in MML.
The information could be updated periodically, and if you have questions, you
need to email me!

Please understand that not having a computer or internet at any given time is
not an extenuating circumstance and that it is your responsibility to make sure
your software and hardware works well in advance of any deadlines.

Initials: ______

I like to know about my students so that I may better help with your success in
this course. Please answer all of the questions below to the best of your ability.
1. How many hours are you taking this semester? (Circle the one that applies. If
attending several institutions, circle the total number.)
1–3 4–6 7 – 10
11 – 14 15 – 18 more than 18

2. How many hours do you work at a job per week? (Circle the one that
applies.)
0 1 – 10 11 – 20
21 – 30 31 – 40 more than 40

revised 8/8/16
Math ______ Information Sheet Section Number _____

3. How many hours per week do you feel you will study outside of class for this
course? (Be as realistic as possible.)
0 1–4 5–9 more than 10

4. Why are you taking this course? (Circle as many as apply)

• I need (next course)__________________ and this is the prerequisite
• My transfer institution requires this as a degree requirement
(Name the Institution _____________;Major:________________)
• Degree requirement for AA/AS
(prospective degree: ______________)
• Repeating for better grade

5. Are you: (Circle as many as apply)

• Dual Credit (grade: 9 10 11 12)
• RCHS (grade: 11 12)
• First Generation College Student
• Transient (Home University:______________)
• Concurrent University Student (University:__________)
• DCCCD student – other than FT Richland College (Home
Campus:_________)
• Richland College student

6. What is your (prospective) major? (Circle the one that applies the best.)
• Engineering (all)
• Business
• Math
• Science (which one? _________)
• Computer Science
• Education
• Certificate (which one? ________)
• History/English/Languages/Art
• Sociology/Psychology
• Other (which one?____________)

Include on page three (in your handwriting) anything else you would like me to
know about you!

revised 8/8/16
Math ______ Information Sheet Section Number _____

I have read all of the information contained in this information sheet and
understand that it is my responsibility to stay in contact with my
instructor.

Signature: _________________________________

Date:____________

Other information for my instructor:

revised 8/8/16