1. Material Interfaces

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* 1. Name:

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* 2. Email:

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* 3. Department and university:

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* 4. Are you:

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* 5. Gender

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* 6. Please rate your previous experience in each of the following areas:
(No previous experience is required. However, a background in electronics will be helpful)

  No experience A little Some A lot It is my primary field of study
Electronics/Electrical Engineering
Materials Science
Industrial Design
Interaction Design
Craft
Art
Computer programming

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* 7. Briefly describe your background, including your previous experience in the areas listed above. If you have an online portfolio, please include a link:

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* 8. How likely are you to register for this class? Note, since this is a lab intensive course, registering as a listener is probably not possible.

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* 9. Briefly describe why you are interested in this class and what you hope to get out of it:

T