Directions: Please take a few minutes to fill out this form. When you have finished, e-mail it to jgranskog@csub.edu. You may also turn it in on Thursday, January 6 in class.  If you are in the AVC class, you may give it to the ITV assistant to be sent to me at the main campus.  You may also turn it into the Instructional Television Network Office or mail to ITV by the end of the first week. The ITV office is located on the CSUB campus in the Stiern Library, Lower Level , east entrance only. If you prefer mailing your profile sheet , please return it to the address below.

Social Security Number: ______________________________
Name:_________________________________________________
Address:______________________________________________
............(City)...................(State).....(Zip)
E-Mail Address: ______________________________________

Main Campus Student: Yes ______ No ______
AVC Student: Yes ______ No ______
Home Phone: ( ) ______________________________________
Work Phone: ( ) ______________________________________
Fax Phone: ( ) _______________________________________

Please indicate any cross-cultural experiences that you have had (e.g. travel in other countries):______________________________________________

_________________________________________________________________________

Have you previously taken a cultural anthropology course?

Yes _____ No _____ 

If yes, specify: _________________________________________________________________

Reason for enrolling in this course: 
General Education Credit _______________
Liberal Studies Major __________________
Other? _________________________________

Instructional Television Network
California State University, Bakersfield
9001 Stockdale Highway, Bakersfield, CA 93311-1099

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