SBVC Biology 270: Microbiology Lab

MICROBIOLOGY STUDENT DATA SHEET

The following information about you and your academic background will be used to help us to better understand your needs. All information will be treated with confidentiality.

Name:______Lab sec: ______Semester: ______

Address:______

Phone #:______e-mail address:______

Student ID#:______

Emergency Contact Person and Phone #:______

1. Academic preparation

Check Classes taken When Grade Comments? courses earned taken Introductory chemistry Chem 101 Additional chemistry Please list

Anatomy (Bio 260) or A&P first semester (250) Physiology (Bio 261) or A&P second semester (Bio 251) Introductory biology (Bio 100, 102) Core biology 200-level courses Algebra (Math 090,095,102) English (Eng. 101,102) Other (Medical Terminology/ Health/etc.)

2. Have you ever been enrolled in Microbiology before this semester? Yes ___ No ____ If yes, please explain the circumstances (when, where, why you are repeating) ______

3. What is your current course load? Total number of units_____ List courses: ______

Continued on back 4. Academic skills self assessment:

Excellent Good Average Weak Very Bad Reading speed Reading comprehension Writing skills (grammar/ spelling)

Verbal Communication Math Problem solving Note taking skills Memorization of facts Comprehension of complex or abstract ideas Test taking skills Stress management Time management Ability to work in teams

5. Do you have any difficulties that could effect your ability to function in the course?

Yes No Difficulty Comments: any special assistance the instructor can provide? Vision Hearing Movement Learning Medical (any condition that weakens immune response)

Psychological Financial Job Transportation Family Other

6. What is your career goal? (Why are you taking this class)? ______

Professor’s comments: ______

Discussed with student: ______