Your Name:

• First Name (the way you would like to be addressed)  
• Last Name  

Number of credits this term:   Select one: 1-6 7-11 12-15 16-18 19+  . . . . Total credits completed:   Select one: 0-30 31-60 61-90 91-120 121+

Major:   

Distance (miles) you currently live from ASU (0 if on campus):   Select one: Less than 1 1-5 6-15 16-30 31-50 51-100 More than 100

Background Information:

    Platform Experience/Exposure

    Programming Experience/Exposure

        Languages (which, when, work/courses):
       

    Database Experience/Exposure

    Web Development Experience/Exposure (prior to this class)

Courses; which?
Experience from work or other source? 

Web programming ability:

	Ability Level
	None	Low	Medium	Strong
HTML
Client-Side Scripting
Server-Side Scripting

Tools used for web page development:

Basic editors

  NotePad or other plain text editors
  Direct HTML editors such as HomeSite, Arachnophilia, etc.

WYSIWYG editors

  Conversion utilities in Word, Excel, etc. (File | Save as Web Page)
  Netscape Composer
  FrontPage
  DreamWeaver
  Others (specify): 

    Primary reason for taking this class:  
       

Work -- Are you working while going to school (or vice versa)? Select one: No Yes

• Where (i.e., employer)?
• In what capacity?
• About how many hours weekly?

Phone number (will not be given out):

• Home   --
• Work    --

Acknowledgement:  I hereby acknowledge receipt of the syllabus for CIT 3353, and I agree to the specifications included therein.  I further certify that I realize this class requires extensive and consistent outside work, along with continuous attendance.  In light of this, I am willing and able to attend all classes and to spend the recommended amount of time daily preparing for the class, unless I am unavoidably prevented from doing so.