Please take the time to fill out this form. Using the information you provide, the account created will keep track of your progress in this module. Your first and last name will serve as your username, but be sure to write down the password that you choose because you will need both your username and password in order to login into the module again.

Upon completion of the module, your instructor will recieve a record of your work by email. Be sure to fill in the correct address for the field labeled "Instructor's Email Address". You will receive a confirmation receipt of your work by an email to the address provided in the field labeled "Your Email Address".