Name: ______________________________________________________________________________

Signature: ___________________________________________________________________________

Identify yourself this way on all assignments and exams submitted for grading, please.

Cornell Student ID Number: ______________________

Email address: _________________________________

Tell us about your previous programming experience, if any. Indicate both the programming languages you studied and how much you studied them. If you have taken CS99 at Cornell, please indicate that. Also, please tell us what your goals are with respect to CS 100.

Signature: ___________________________________________Date: ___________________________

If I don’t attach a cover sheet to my assignment clearly requesting that it be kept confidential, I understand that it may be made available for return in Carpenter. (Note that all assignments will be returned inside campus mail envelopes.)

Signature: ___________________________________________Date: ___________________________

Complete one of the following parts:

I. I, ____________________________________________ consent to the use of my student id number for the purpose of posting of grades for CS100 for Summer 1999, thereby waiving my rights in this regard under the Family Educational Rights and Privacy Act of 1971. I understand that such consent is not required by the University, and I affirm that it is in all respects freely and voluntarily given.

I understand that this waiver will be retained by the instructor in charge of the course for a period of one year following its expiration.

Signature: ___________________________________________Date: ___________________________

II. If you do not wish to sign the waiver, please enter four digit number below, and make a note of it. This number will be used instead of your ID number to post your grades. If you choose to enter a four-digit number, make sure you don’t forget it!

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