Student Information Form

Please fill in this form. When you press the "submit" button, a copy of your responses will be E-mailed to both you (alternative e-mail address) and the professor. Fields that must be filled in are indicated by *

This record is for the current or next offering of (check both if appropriate) *
ChE804
ChE805
Che806

First Name *:

Middle Name or initial:

Last (family) Name *:

(*) Briefly summarize your educational background (previous degrees and yrs, etc.). Comment on your scientific background if you do not have a B.S. in natural science or engineering. Briefly summarize how the course fits into your educational plans. This information is important for the instruction, and also will be shared with your classmates.

(*) Please share an interesting fact about yourself or hobby to share with the class. Here are some of your instructors:
804, Lira: I have a German shepherd, I like to tinker with computers and software. I help maintain the dept website.
805, Worden: I have an undergraduate degree in Liberal Arts, with majors in Chemistry and Cell Biology. My hobbies include fishing and playing sports.

Please provide your location (City, State or City, Country) that can be listed to share with the class, (e.g. East Lansing, MI):

Please provide a mailing address a course certificate at the end of the class:

*MSUnet username (normally used to send e-mail to your msu.edu account; be careful not to make typos! Your MSUnet username is established when you activate your system using PIN and PAN. If you don't know it yet, just enter 'unknown'.)

*Alternative email address (used in case MSUnet is not working)

*Codename (The codename will be required when you edit this infomation. The codename is listed rather than personal information to identify your record. )
* Password not used on any other sites (Max length 20 characters.)

Daytime phone: Evening phone:
FAX number:

(4) Please indicate your planned enrollment status. The enrollment options are summarized at https://engineering.msu.edu/about/departments/chems/continuing-education/enrollment-process. If you are enrolled at MSU and want to take the course in a non-graded status or audit, you must change VERY EARLY IN THE COURSE (by the 2nd or 3rd day in the summer, and the first week or so in an ordinary semester).

*Enrollment Status (This tells me of your intent. IT DOES NOT MAKE THE CHANGE OF STATUS FOR YOU):

I am taking the course for credit as a lifelong ed or MSU degree student, so I will complete quizzes, final and all homework.

I am taking the course as part of the graduate certificate Foundations in Chemical Engineering. I understand that I must apply separately for that program instead of lifelong education status.

I am only auditing the course, and won't be submitting any work.