AD 372 - Graphic Design 1 |Fall 2016

Studen t Informatio n
The information you provide on this sheet will remain confidential. I use these forms primarily to get a sense of
what your academic background is and where your interests lie. However, I do sometimes distribute course
information (cancellations, changes in reading assignments, etc.) via email, and if you miss a project or stop
attending class entirely, I may call or email you to check to see if you're still enrolled.
Last name

First name

MI

The name you actually go by (if different from above):

Major/Area of study
Phone number

Year of study
Email address

You will need to regularly check your SIUC email as it will be used as the main method for outside of class
communic ati on and notification of course changes.
Do you know how to perform basic searches for tutorials, scholarly books, and articles?
What do you hope to learn in this course?
Are there any topics/issues you would particularly like to see covered in this course?
Are there any factors that might affect your work for this course that you would like me to be aware of (e.g., you
have a learning disability, you work full-time, English is not your native language, you have a family member who is
not well)?
You do not need to share this information with me, and in fact even if I know your life is falling apart I can still only
grade you on your performance, but I will at least be more sympathetic if I know your situation. Feel free to
continue on the back of the page if necessar y. Note: If you need special classroom and/or testing arrangements ,
please let me know during the first week of classes (please provide written documentation from DSS or Achieve
that specifies the arrangem ents you need).

I hereby certify that I have received a copy of the course syllabus and that I understand the course policies as
explain ed. I understan d and give consen t that my work may be shown and used for course examples and
possible school publicity or promotion.

Signature:

date: