CS333 Background Survey Form

CS333-Web Online Course
Student Background Survey

Last name:
First name:
Student ID#(exactly 9 characters - no dashes):	(OPTIONAL)
Email:
UNIX login ID (if known):
Personal WebPage (optional):
Phone number:

Major:
If your major does not appear, enter it here

Transfer Student?

No
Yes

Class	Grade Option

BACKGROUND INFORMATION: Please indicate level of experience.

C/C++	Pascal	Fortran

Visual Basic	Java

Math (check all that apply)	Science (check all that apply)
(Use shift or control key with mouse to make multiple selections)

Besides I also have the following relevant background (other languages/work experience, etc)