Questionnaire

Students Interested in Enrolling in PS56 Regulating Citizenship

Spring Semester 2009 

Name, year, and major (if declared):

 

Why are you interested in taking this course?

 

What related courses have you taken?

 

What special interests or talents would you bring to the class?

 

Do you have any concerns about learning inside a prison or being in a classroom with incarcerated persons?

 

Circle your level of commitment to this learning experience:

Like Any Other Course             High                 Top Priority

 

What other academic or extracurricular activities will you be involved in during the Spring Semester (such as thesis writing, sports team, etc.) and how will it affect your participation?

 

May I contact a current or former instructor for a recommendation? If so, who should I contact?

 

The following two questions provide information necessary for the process of obtaining security clearance to enter the correctional facility.

Do you have an arrest or conviction record?

 

Do you have relatives or friends (you have visited) in any prison system in the United States?

 

Other comments?

 

Please answer these questions, save as a WORD file and e-mail as an attachment to kbumiller@amherst.edu. Please understand that I will make every effort to interview all interested students, but depending on the level of interest this may not be possible. All students who have completed a questionnaire will be notified about permission to enroll in the course before the end of registration week.

Please submit your application by NOVEMBER 3.

Thank you, Kristin Bumiller.