Student Information Sheet
Privacy Statement
Department of Educational Psychology
Please complete this data for us. All information is for UNIVERSITY USE ONLY and will remain confidential and secure. Note: This form will not update your information in the Registrar's office. Go to Iservices to check and update your contact information at the Registrar's office.
Please complete this form for each Department of Educational Psychology Distance Education course that you are taking. Click < Submit> and use the 'Return to the form' link or the 'Back' button on your browser to complete the form for the next course. If this information is not entered correctly, your instructor will not have a record of your submission.
Are you enrolled in any traditional 'On campus' classes at the UNT - Denton location this semester? (Enter YES if any of your classes primarily meet daily/weekly on campus. Enter NO if all of your other classes are primarily WEB or VTEL instructed, even if the classes have a meeting for the 1st class or for exams only.) NOYES
Student ID Number (ex: 12345678)
First name: Last name:
List information on one course in which you have enrolled..
Program
Course #
Section #
Instructors Name
Semester Enrolled
ex: EDSP
5150
020
Dr. Ann Smith
Fall 2007
DFST EDSPEPSY
020021022023024025030031032033040045049???
Fall 2008May-Mester 2008 Summer I 2008Summer II 2008 Spring 2009
Current Address:
Address (ex: 123 Peach Street # 3A)
City State TexasAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTenneseeUtahVermontVirginiaWashingtonWashington, D.C.West VirginiaWisconsinWyoming Zip code
Mailing Address (**If different than Current Address**)
Address (ex: P.O. Box 123)
Phone Numbers (ex: 940-555-1212) Enter at least one so we have a way to contact you should the need arise.
Home
Work
Cell
Fax
Email address (ex: IMSure@unt.edu)
Alternate email addresss (ex: myhome23@AOL.com)
Can We Help You?
Do you have any questions or any concerns about this form, distance education from UNT and the Department of Educational Psychology? Please use the space below to let us know. If you have course specific questions, please contact your Instructor directly.
(Please do not use the enter key or tab key when typing...just enter your comments as a continuous line of text with periods and spaces. Using the enter or tab keys scrambles the text that is sent to us.)
Send this information---click Submit and wait for the confirmation message. Then, use the 'Back' button on your browser to submit the next course in which you are currently enrolled.
Erase the data and start again