Name:

Academic Title:

Department:

Office Location:

Office Hours:

(NOTE: Students from your assigned group will be delivering an Adopt-a-Prof kit to you during designated office hours)

Phone Number:

E-mail:

Academic area(s) of expertise:

Courses you are teaching Fall 2009-10:

Interests, travel experiences, hobbies and/or other information that would be useful in the student group matching process:

Family Information: (OPTIONAL)


This information is requested because students groups often enjoy including family members in certain family-friendly activities.


You will be contacted very soon with information about your assigned Adopt-a-Prof group.