Name:                                                          Preferred email address:

Educational background:

Work experience

Job duties:

Access to a personal computer (check all that apply): ____ home ____ office _____ other

Access to the internet (check all that apply)   ____ home _____ office _____ other 

Describe the extent of your experience in the following areas (be specific):

Chat:

E-mail

Internet Games

Internet Newsgroups

World Wide Web

Other (please list)


List programming languages you have studied or used or web page design experience (if any):

 

Please list anything related to the course not listed above where you have some knowledge or experience which might the basis for a short presentation sometime during the course

 

 

 

If there are specific things you want to learn from this course, please list them:

 

 

 

Why are you taking this course?