Fact Sheet . . .

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This fact sheet summarizes the following information about you: general, academic background, and current commitments. Please provide the date that you submit information.

     General Information

Name (as on records):

Preferred name:

Email addresses:
    First (preferred) –
    Second –

Instant messaging user id:

Postal address:

Student number:

Home phone number:

Work phone number:

     Academic Background Information

 
BA/BS degree (where, when received or anticipated, major, minor):

Post-baccalaureate degrees (where, when received or anticipated, major, minor):

Current work, both full time and part time (job title plus brief description of your job tasks):

Future career objectives:

Background in communication courses and work experience (summarize):

Background in "technical" or specific subject area(s) courses and work experience (summarize):

Computer and technology experience:

Hardware—

Software—

Other technology such as scanning and projection systems—

 Access to computer(s)—

     Current Commitments

 
Briefly indicate schedule (such as classes, work, any set commitments):

Other factors (such as children, health, and commuting from outside of Greenville area):