SU12 Math 215 SLA Registration Form
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1
. Please provide some information about yourself:
Please provide some information about yourself:
First Name:
Last Name:
City/Town:
State:
-- select state --
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
Zip Code:
Franklin Email:
Phone Number:
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2
. Math 215 Instructor's Name
Math 215 Instructor's Name
Anthony VanderHorst
Charles Peselnick
Clayton Rothenbush
Cynthia Cannizzo
Heather Houchard
Klaus Fricke
Mark Marino
Mary Hemby
Michelle Wilson
Ronnie Catipon
Ronnie Kerlee
Thomas Foltz
Todd Hoff
Wendy Neaville
Other (please specify)
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3
. I am taking the Math 215 class
I am taking the Math 215 class
Online
Face-to-face
4
. What day does your class meet? (If applicable)
What day does your class meet? (If applicable)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
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5
. Did you take Math 150 at Franklin University?
Did you take Math 150 at Franklin University?
Yes
No
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6
. Have you ever registered for Math 215 at Franklin prior to this term?
Have you ever registered for Math 215 at Franklin prior to this term?
Yes
No
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7
. How long has it been since you took a Math class?
How long has it been since you took a Math class?
0-2 years
3-5 years
6-10 years
10+ years
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8
. How comfortable do you feel going into this class?
How comfortable do you feel going into this class?
Very uncomfortable
Somewhat uncomfortable
Somewhat comfortable
Very comfortable
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9
. SLA Participant Agreement
SLA program is completely voluntary, however, once you register, you agree to the following:
-Regular participation. Students may not miss more than three consecutive sessions, otherwise, you may lose your place in the program.
-Class attendance. SLA is not a substitute for class. Students are expected to attend class regularly. Should you miss a class, please make arrangements to "flex" into another section or talk to your instructor for make-up instructions.
-Active participation. Students are expected to prepare for SLA by completing homework problems, preparing questions and participating in the discussion.
-Instructor notification. Your instructor will be notified of your participation in the SLA program.
-Adherence to the Franklin University Student Code of Conduct
SLA Participant Agreement SLA program is completely voluntary, however, once you register, you agree to the following: -Regular participation. Students may not miss more than three consecutive sessions, otherwise, you may lose your place in the program. -Class attendance. SLA is not a substitute for class. Students are expected to attend class regularly. Should you miss a class, please make arrangements to "flex" into another section or talk to your instructor for make-up instructions. -Active participation. Students are expected to prepare for SLA by completing homework problems, preparing questions and participating in the discussion. -Instructor notification. Your instructor will be notified of your participation in the SLA program. -Adherence to the Franklin University Student Code of Conduct
I agree
I do not agree
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10
. Please select a day to attend Structured Learning Assistance for the entire term. Once you register for a specific section, it may not be possible to change sections.
Please select a day to attend Structured Learning Assistance for the entire term. Once you register for a specific section, it may not be possible to change sections.
Wednesdays from 8-10 p.m. on FranklinLive! (online)
Thursdays from 8-10 p.m. on FranklinLive (online)
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