EDS 39 Authorization Form ~ Spring 2012

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EDS 39/ Spring 2012
Luz Chung
Pepper Canyon 304 ~ 3:30-4:50pm

First Name *

Last Name *

Email Address *

Student PID # *

Local Address *

Local/Cell Phone *

Have you taken Math or Chem 87? *

Yes

If yes, what quarter and year?

Have you taken EDS 39? *

Yes

If yes, what quarter and year?

If you have not taken EDS 39 and you plan on taking it, when will you take it?

(Quarter and Year)

Are you planning to minor in Education Studies? *

If so, please select which minor.

General Education Studies Minor

Math Education Minor

Science Education Minor

Not planning to declare a minor.

What other Education Studies classes have you taken?

Why are you interested in the class?

How did you hear about EDS 39? *

Submit

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