ENROLLMENT FORM - FALL 2022

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Please answer the questions below to the best of your ability. By providing this information you will help me gain a better understanding of your personal needs and goals. I hope to use this information to better your learning experience in my course.

LAST NAME, First name ("Name you go by") / pronoun *

Example: Montero, Elizabeth ("Liz") / she - her - hers

Course / Title *

SPAN221: Intro to Hispanic Lits & Adv Practice in Spanish

SPAN251: Urban Fantasies

Class year *

Carrera (major; actual or intended) *

Academic advisor *

Last name / department (Example: "González / RLL")

Permanent address *

Example: 293 Main St.; Berkeley, CA 94720

Emergency contact telephone *

Example: 510 342 1243 (my cell)

How long / where have you studied Spanish? *

Example: 4 years High School Spanish; summer travel in Mexico; Spanish spoken in my home

Tell me about the courses you have taken that you feel prepare you for this one *

Other languages? *

Identify the language(s), years of study and level of competence. Example: Portuguese - 2 years - intermediate. (Levels: elem - inter - advanced - native or near native)

Experiences abroad (where, when, how long) *

Examples: Exchange student / Portugal (summer 2009); High School trip / Spain (April 2011)

What works of literature, art, music, or dance, or what other cultural experiences have had the greatest impact on you over the past few years? *

What do you hope to gain from this course? *

Is there anything in particular I should know about your learning style or personal needs? *

HONOR PLEDGE *

I have read the paragraph pertaining to the Wesleyan HONOR CODE that is included in the online course description ("Presentación"). Specifically, I have taken note of the passages concerning electronic devices and, under the oath of the Honor Code and by submitting this form, I pledge to adhere strictly to those guidelines.

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