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Student Information Sheet                                                                        
CHM130 for Quinn Thacker and Ken Costello's classes


Student Name: 




CHM 130 Fundamental Chemistry Class #:

CHM 130LL Chemistry Lab Class #:


1.      List the chemistry course that you last took:

When? ________________________

2.      Who recommended this Instructor or class to you?

3.      Do you plan to take more chemistry after this course?  

If yes, what course(s) do you plan to take?

4.      Why are you taking this Chemistry course?

If this course is required for your major, indicate your major:

5.      Math class you have taken most recently:

6.      How many credit hours are you taking this semester?  

7.      If you are working, how many hours per week do you work? 

8.      How many hours per week do you plan to study for this course? 

9.      Comments/Other Information that you wish the Instructor to know:

10.    I have received the course syllabus for the class(es) for which I am enrolled; I am responsible to read and understand its content; and Instructor and I are obligated and bound by it.  I understand that the Instructor is available to assist students individually or as a group; and Instructor is available to assist student(s) at Instructor’s tutoring times and/or by appointment if requested.

By submitting this information by email, it will be the equivalent as signing it.

Email this information to one of the instructors for the online CHM130 classes:
Quinn Thacker: QRT2004@yahoo.com
Ken Costello:  chm130pc@chemistryland.com