1. Name                                                                                                      

2. Local Address                                                                        

                                                                                                  
                                
 
3. Phone                                                                        

4. e-mail                                                                        

5. Current Semester at Samford (Number)                         

6. Other Course(s) This Semester

1.                                                           4.                                                    

2.                                                           5.                                                    

3.                                                           6.                                                    

7. Work (Name, and Hours Per Week Working)
                                                                                                                                         
                                                                                                                                         
                                                                                                                                        

8. Special Achievements and Interests
                                                                                                                                         
                                                                                                                                         
                                                                                                                                        

9. Computer Proficiency (Word Processing, e-mail, WWW, PowerPoint, etc.)
                                                                                                                                         
                                                                                                                                         
                                                                                                                                        

10. Please write a few paragraphs on your expectations for this course. What do you hope/expect to learn in UCCA 102? What do you think you won’t like? Anything you "fear" about the course?