Section Number:

Phone:
Give me a phone number where I can reach you most easily. I prefer a cell phone or phone number with an answering machine whenever possible.

     Area Code Phone Number (use hyphen)
   Last Name:    First Name:

E-mail Policy: You must have a working e-mail account you check regularly. You are responsible for providing me with a correct e-mail address, for using that same e-mail address in all correspondence, for checking it daily for communication from me, and for saving all e-mail messages from me in order to resolve any grading disputes, etc. By submitting this form, you are agreeing to abide by this policy.

Fill in your e-mail address very carefully!! If you have any errors, your work will not be sent over the Internet to me. Microsoft offers free e-mail accounts at Hotmail and Yahoo offers free e-mail accounts at Yahoo.com.

E-mail Address: 

Click the Submit button and your questionnaire will be e-mailed to me automatically.
Note: To protect your privacy after filling in this form, do this: In the Internet Explorer browser window, click Tools, Internet Options, Content tab, AutoComplete button, Clear Forms button, OK, OK; close and reopen the browser. If you can't remember these steps, just return to this page and follow them from here.
 

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  • This site and its contents are © 2003 [Arlene Zimmerly] and may not be reproduced in any form without prior written permission. All rights reserved. Best viewed in Internet Explorer, 1024 x 768 resolution. Revised December 18, 2006.