First Name:         Last Name:

Year: FirstSecondThirdFourthOtherPost-Grad

E-Mail Address:

Local Telephone Number(s):

Place a check mark beside the course(s) related to KINE 3253 that you have taken or are currently taking:

Other Relevant courses, diplomas, degrees (e.g. political science, sociology, philosophy, etc).

Concentration/Specialization or sub-disciplinary interest(s):

Past and current key roles in sport and physical fitness/activity (volunteer, employee, participant/team member, etc.):

Career objectives/plans (tentative or firm):

Three questions you have about sport and/or physical activity in society:

1.

2.

3.

Three favourite movies/books with a sport or physical activity theme (note if book or film):

1.
2.
3.

Once you have completed the evaluation, please click the submit button: