lesson cover sheet_2-2011.p65 - LSU Independent and Distance
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LESSON COVER SHEET Independent & Distance Learning 1225 Pleasant Hall Louisiana State University Baton Rouge, LA 70803 Website: A cover sheet should be completed, folded on the dotted line, and submitted with each lesson. www.outreach.lsu.edu/idl Lesson Number ______________________________ Telephone: Learner Services: (225) 578-2500 • 800-234-5046 E-mail: Dept & Number ______________________________ answers@outreach.lsu.edu This lesson will be returned to you in a window envelope. Please write or print your complete address clearly in ink. Then fold this cover sheet on the dotted line below so that the address will appear in the window. Enrollment Number ___________________________ To be completed by the Instructor: Name_________________________________________________________________ Street or Box ________________________________________________ Apt_______ City______________________________________State_______ Zip ______________ Lesson Grade: _________________________________ _____________________________________________ Instructor’s Signature Date: ________________________________________ (Fold along this line) Instructor’s Comments: LESSON COVER SHEET Independent & Distance Learning 1225 Pleasant Hall Louisiana State University Baton Rouge, LA 70803 Website: A cover sheet should be completed, folded on the dotted line, and submitted with each lesson. www.outreach.lsu.edu/idl Lesson Number ______________________________ Telephone: Learner Services: (225) 578-2500 • 800-234-5046 E-mail: Dept & Number ______________________________ answers@outreach.lsu.edu This lesson will be returned to you in a window envelope. Please write or print your complete address clearly in ink. Then fold this cover sheet on the dotted line below so that the address will appear in the window. Enrollment Number ___________________________ To be completed by the Instructor: Name_________________________________________________________________ Street or Box ________________________________________________ Apt_______ City______________________________________State_______ Zip ______________ Lesson Grade: _________________________________ _____________________________________________ Instructor’s Signature Date: ________________________________________ Instructor’s Comments: (Fold along this line)
