Student Application

First Name
Last Name
Major
Year
Home Address 1
Home Address 2
Home City
Home State
Home Zip Code
Residence Hall
Room Number
Local Address 1 (CS Unit if on-campus)
Local Address 2
Local City
Local State
Local Zip Code
Home Phone
Local Phone
Referred by

What OS's do you know well (setup, advanced configuration, etc)?	Macintosh DOS Linux Windows XP Windows Vista
What software do you know well?	Microsoft Office Word Perfect Adobe Photoshop Outlook Express Windows Mail Mozilla Firefox Internet Explorer
What Anti-Virus program do you use?	Sophos Anti-Virus Norton Anti-Virus Mcafee Anti-Virus
Do you know any of these programming languages?	C/C++ HTML PHP Cold Fusion Visual Basic
What are your 3 favorite web sites?
Have you used the services provided by the Techonogy Support Center? (If yes, give brief description)
Do you have any customer service experience (especially on the phone)?
If you have experience working with hardware, list your experience here: