Instructor Answers Keys Registration Form
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Instructor Information
First Name   Last Name
Address   City
State   Country
Zip Code   Email
Day Phone Ex. Ext   Eve Phone Ex. Ext
Title / Class Information
What is your title:
What is your course name?
Name of the institution you teach for
How many students are in your class?
List books you currently use?
List classes you currently teach
Experience
How often do you teach the class?
Can you send a copy of your syllabus? Yes No
What other courses would you like to teach?
Materials Resources
Do you use Mike Holt materials? Yes No
If so, what materials do you use?
Continuing Education
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If yes, please describe
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