Midlands Technical College
CPT 170 - Student Information Form

 

Instructions: You must complete the form online and then submit it online by clicking the "Submit" button at the bottom of the page. 

Please provide the following information:

Name
Course (use drop-down arrow to select)
Section (use drop-down arrow to select)
Phone Number 1 (format: 803-555-1234)
Phone Number 2 (format: 803-555-1234)
Email Address
Major
Expected Graduation Date (ex. May 2006)
Have you taken CPT 101? (use drop-down arrow to select)
Do you have a computer at home? (use drop-down arrow to select)

Reasons for taking this course: (Please be brief) [Limit 10 lines]

Level of Experience with the Microsoft Office: [Limit 5 lines]

Comments: [Limit 10 lines]

  

Author: Stamarian Watts, Midlands Technical College, IST Department
Revised: January 13, 2009