Nihongo Web Contract
I have read all, understand all, and agree to all the conditions and terms of the Nihongo Web Syllabus. I understand that I, the student, must sign and date this form and return it to Laurie Arizumi at The University of Alabama Box 870246, Tuscaloosa, AL 35487 before I can begin any level of the Nihongo Web course.
Student Name Printed:_______________________________________________
Student Name Signed: _______________________________________________
Mailing Address (street, city, state, zip): _________________________________
____________________________________________________________ ____
Email: __________________________________________________________
Today’s Date: ___________________________________
Japanese level (1, 2, or 3): ___________
Course Start Date (Day/Month/Year): __________________________________
Type (check only 1 option):
____High School
____Home School
____Dual Credit (signed up for college credit and high school credit)
____College Credit only
____Independent Study (non credit)
Proctor’s name, phone, title, institution and email address:
Student’s high school address and phone number if applicable: