ENGLISH 1102-B6 SHAKESPEARE AND THE MAPPING OF DIFFERENCE Writing and Communication Program School of Literature, Media, and

Communication Georgia Institute of Technology Spring 2014 Andrew Bozio Course Hours: MWF 11:05-11:55 Office Hours: MTTh 4:00-5:00, and by appointment [email protected] Course Location: Skiles 370 Office Location: Skiles 315

COURSE DESCRIPTION
Shortly before Shakespeare began writing for the Globe Theater, Francis Drake became the first Englishman to circumnavigate the world, and his tales of distant lands and different cultures gave rise to many early modern fantasies about the world beyond England. Like space itself, the meanings that we attach to an environment are multimodal; that is to say, they exist within and across different domains, and they partake of visual, acoustic, and tactile signifiers as readily as they are shaped by language. In this class, we will seek to become better thinkers, writers, and communicators by asking how spaces early modern as well as contemporary are shaped. The Renaissance witnessed not only the rise of cartography but also the conceptual and economic foundations of what would become the global slave trade, with the effects still palpable within our own culture. By studying a diversity of artifacts including contemporary theory, early modern drama and prose, and both digital and non-digital cartographies students will gain a more nuanced understanding of the political dimension of space, in Shakespeares day as well as our own. More importantly, they will become more advanced as interpreters and creators of cultural artifacts. To ground our inquiry, we will read Thomas Mores Utopia, Christopher Marlowes Tamburlaine I and II, and Shakespeares Othello, with an attention to the way that racial and ethnic difference becomes reified (or disrupted) when spaces are mapped. Our emphasis will lie in evaluating the efficacy of the various claims we encounter and finding ways to develop our own work in response. For this reason, students will also read short theoretical works, including Michel Foucaults Of Other Spaces, to deepen their vocabulary for critical thinking. Working closely with digital archives of early modern cartography, as well as with the upcoming exhibition at the Paper Museum Mapping Place: Africa Beyond Paper students will gain fluency in working with visual, digital, and non-verbal representations of space. In a major project, students will then be expected to create a digital map that layers visual, aural, and discursive elements together to create a sense of a particular space. Students will also write an essay that combines written and visual analysis, and their final project for the course will be an oral presentation that incorporates multimodal design into its argument. Through this work, students will not only gain an introduction to major works of early modern literature and culture. They will also develop skills in close reading, in selecting and using evidence, and in analyzing visual and digital artifacts. In short, participants in this course will become more advanced in their thinking and in their ability to produce multimodal arguments about literature, culture, and space.

Bozio, Syllabus for English 1102

LEARNING GOALS
In addition to the learning goals listed below, there are course outcomes that are common to all sections of English 1102, which you can find at goo.gl/niuy0c. Through this course, you should: 1) Deepen your critical thinking skills through reading, analyzing, discussing, and synthesizing complex works 2) Acquire the skills of written, oral, visual, electronic, and nonverbal argumentation necessary to succeed at the college level 3) Develop intellectual habits of inquiry, in which you are able to engage new opinions and information with curiosity, critical thought, and respect 4) Become adept at interpreting the way that spaces are created and made significant 5) Achieve an introductory understanding of the representation of race in early modern culture

REQUIRED TEXTS
Thomas More, Utopia (New York: Norton, 2010) ISBN: 039393246X Christopher Marlowe, The Complete Plays (New York: Penguin, 2003) ISBN: 0140436332 William Shakespeare, Othello (London: Arden, 1996) ISBN: 1903436451 WOVENText, available at ebooks.bfwpub.com/gatech.php

GRADE DISTRIBUTION
Paper (1250 words) Cartographic Project Oral Presentation Blog Posts Reflective Portfolio Class Participation Participation in Peer Workshops 15% 20% 15% 15% 15% 15% 5%

COURSE POLICIES
As with course outcomes, there are policies that are common to all sections of English 1102, which you can find at goo.gl/niuy0c. Below, you will find elaborations of those policies that are specific to this section. Attendance Because this course is a collaborative effort, your attendance is essential both to your success and the success of the class as a whole. Nevertheless, you may miss up to four classes without penalty, in addition to other absences that are officially excused by the Institute. Should you miss more than four classes, your grade will decrease one-third of a letter grade (e.g., from a B+ to a B) for each absence, and eight absences will result in failure for the course. Repeated lateness will also affect your participation grade (being late three times will be equivalent to one absence and will be marked accordingly). You are responsible for making up any and all work that you miss during your absence. Bozio, Syllabus for English 1102 2

Participation Again, this course is a collaborative effort, in which you will work with me and with your peers to develop skills in critical thinking and argumentation. Accordingly, I ask that you come to class prepared. On days for which reading has been assigned, this means that, beyond having read the text, you will have thought critically about the reading and have taken notes to help you voice that thinking in class discussion. You should plan to speak regularly in class, since our discussions depend upon your involvement for their success. I will grade your participation based on the substance of your contributions and your ability to further the conversation. On days in which there are small group workshops, you should come to class with a full draft of your assignment, ready to discuss it with your peers. You will be working in small groups of five to revise your work, and your efforts there represent 5% of your final grade. Statement of Non-Discrimination This class does not discriminate on the basis of race, color, age, class, religion, national origin, gender, sexual orientation, marital status, disability, or status as a veteran. Indeed, alternative viewpoints are welcome. For this reason, all comments must be delivered in a respectful manner. Statements that are deemed racist, sexist, homophobic, classist, or otherwise discriminatory toward others will not be tolerated. Accommodations Anyone who anticipates difficulties with the content or format of the course should arrange to meet with me so we can create a workable plan for your success in this course. For those students who have a documented, qualifying disability, Georgia Tech supports students through ADAPTS (Access Disabled Assistance Program for Tech Students). The program operates under the guidelines of Section 504 of the Rehabilitation Act of 1973 and the 1990 Americans with Disabilities Act (ADA). - Visit Smithgall Student Services Building, 353 Ferst Drive, Suite 210 - Email: [email protected] - Call: 404-894-2563 (V), 404-894-1664 (TDD), 404-894-9928 (Fax) Because official documentation of the disability is required to determine eligibility for accommodations or adaptations that may be helpful for this course, please make sure that I receive a Faculty Accommodation Letter form verifying your disability and specifying the accommodation you need early in the semester. Technology Students are encouraged to bring laptops and iOS devices (such as smartphones, iPads, and Kindles) to class. Since participation requires ones full attention, however, I ask that students use these technologies only in the service of the courses learning goals while they are in class. Some assignments will require you to work online, to browse popular websites, and to engage social media. Otherwise, you should refrain from using your devices. Failure to adhere to the policy on technology will mean that you are considered absent for the day, with significant consequences for your grade. In this course, we will be using T-Square, Omeka, Wordpress, and other digital tools. If you do not already have accounts with each of these sites, you will need to create one as soon as possible. To access the course site on WordPress, you will need to create an account and then accept my email invitation to join the site. I would encourage you to use a pseudonym that does not reveal your identity. This will allow you to practice writing public-facing documents in the form of blog posts Bozio, Syllabus for English 1102 3

without the concern that your posts will always be a part of your online identity. If you run into problems, get in touch with me, or seek assistance from one of the many IT resources on campus, such as the Multimedia Studio in the Commons. Communication Center Georgia Techs Communication Center is located in Clough Commons, Suite 447. It is an excellent resource for all students who want help with a communications-related project, including assignments for this course (papers, oral presentations, and website design) multimodal projects (such as storyboards, videos, and poster designs), engineering and science reports, and professional materials (including grant proposals, job cover letters, resumes, and graduate school applications). You can visit the center at any stage of the process of any project, regardless of the discipline. The staff is available to help you develop and revise your projects, and their services are both free and confidential. While the tutors will not be available to fix your projects you shouldnt expect them to edit or proofread your materials they can offer constructive criticism that will help you improve your work. To make an appointment, visit: http://communicationcenter.gatech.edu/content/make-appointment. If you need assistance with the appointment system, call 404-385-3612 or visit the center. Contacting Me I typically respond to emails in the afternoon, so leave plenty of time for me to answer your questions. Also, please feel free to visit me in office hours with your questions and concerns about the class. In particular, I am happy to help you think through problems that may arise as you develop your projects. While I will not read entire drafts, I can comment on a specific aspect of the work, so come to my office with your questions in mind. If you are unable to meet during my office hours, email me at [email protected] and we can set up an alternative time. Syllabus Modification This syllabus may be modified as the semester progresses. In response to midterm evaluations, as well as more informal feedback, I may change the required reading and the assignment schedule in order to achieve the learning goals of the course and to address the needs of the students.

ASSIGNMENTS
WOVEN Communication This course will help you to become a better thinker and communicator. For our purposes, communication exists within several modalities written, oral, visual, electronic, and nonverbal and you should expect to develop greater fluency with these modalities through specific assignments. In practice, of course, these modalities overlap and support one another, and so many projects may address different modes of communication simultaneously. Written Communication: Through essays and analysis of written material, you will refine your ability to interpret and to produce polished prose. Oral Communication: Through oral presentations and regular participation in discussion, you will become more adept at public speaking. Visual Communication: Through website design and in-class exercises, you will acquire a more nuanced understanding of the way that images create and disseminate information.

Bozio, Syllabus for English 1102

Electronic Communication: Through blog posts and regular interaction with digital interfaces, you will gain greater fluency in electronic communication, as well as an ability to critically evaluate such discourse. Nonverbal Communication: Through analysis of performances and public speaking, you will gain a greater appreciation for the way that body language, eye contact, and other nonverbal cues make meaning. Paper In a 1250 word essay, craft an argument about the relationship between England and Utopia in Thomas Mores work. Although More repeatedly suggests that Utopia is a real place, the fictional island allows the author to offer a thinly-veiled critique of his native England. How do these fictional and historical spaces inform one another in the Utopia? Your essay should attempt to answer this question by analyzing the relationship between Mores fantasy of the New World and early modern England. Cartography Project For this assignment, create a digital map of a particular space in Marlowe's Tamburlaine, using images, videos, and literary analysis to offer a critical perspective on the topographies of the play. Your space may be a city that Tamburlaine occupies or a route that the Scythian shepherd follows in his conquests. To map the space, you should select a platform (such as Neatline or Google Maps) and create a layered map that tags specific locations with multimodal artifacts and passages from the play. The learning goals of this project are three-fold. First, you should increase your digital literacy (in other words, your ability to use and to interpret digital media). Second, you should develop skills as an independent researcher. Finally, you should deepen your understanding of the ways that history, material culture, and literature inform one another. In evaluating your project, I will be looking to see how well your work displays fluency in these areas. For examples of layered maps, visit http://neatline.org/neatline-in-action/. In particular, the second example (Jedediah Hotchkiss and the Battle of Chancellorsville) shows how text, image, and cartographic representation can be combined to offer a critical interpretation of a particular environment. Oral Presentation In a five-minute oral presentation, present an argument about how two performances or film versions of Othello differ in their approach to the text and what this difference means for our understanding of the play. Rather than discuss the entire play, you should focus on one passage, and consider how specific choices whether on the part of the actor or the director shape the significance of that passage. Use a Prezi or a Powerpoint presentation that includes clips, stills, or audio from the productions that you are discussing as evidence for your claims. Small Group Workshops Before each major assignment is due, you will have the chance to workshop multiple versions of the project in small groups. These groups will change over the course of the semester, giving you the opportunity to give and receive feedback from all of your classmates. On the first day of workshops, you must bring a full draft of the assignment to class. An outline or collection of notes will not suffice, since our ideas often change as we articulate them. After your workshop, take the Bozio, Syllabus for English 1102 5

opportunity to revise your work in response to what your peers have said. Keep track of these developments, and make sure that you save each version of your work. When you submit the final version of your project, you should also include a one-page letter that describes how you revised your project in response to the suggestions of your peers. Blog Posts Over the course of the semester, you will write four posts on the course blog, each one corresponding to a chapter or essay that we are reading for class. In your post, identify the thesis of the chapter or essay, as well as whatever claims you find most interesting, perplexing, or provocative. Does the argument change or deepen your understanding of the literature that were reading? Blog posts are due at 8:00 pm on the night before we are scheduled to meet, and they should be between 250 and 500 words. These posts will be visible to the entire class, as well as to the wider public. Again, for this reason, I would encourage you to use a pseudonym that does not reveal your identity. This will allow you to practice writing public-facing documents without the concern that your posts will always be a part of your online identity. I grade blog posts on a five-point scale, taking into account your efforts to think through the reading. Reading Quizzes There may be short reading quizzes at the start of class to ensure that everyone is keeping up with the reading. They will not be complex. As long as you are reading the texts carefully, you should have no trouble. These will factor into your participation grade. Reflective Portfolio Your Reflective Portfolio will include the three majors assignments described above, the three letters describing your revision process, a collection of your blog posts, and an additional statement that chronicles your growth over the course of the semester. You will have the opportunity to compile these materials and revise them into a Reflective Portfolio during the Week Prior to Final Exams. Week Preceding Final Exams (WPFE) There will be no quizzes or exams during the WPFE, nor any new assignments. The purpose of the WPFE is to allow to you to assemble and to revise your projects into a Reflective Portfolio. To this end, all course work will be graded and returned to you before the last day of classes. You should plan to work on your portfolio periodically throughout the semester, with significant work being undertaken the WPFE, both in and out of class. The portfolio is due on T-Square at the start of this courses scheduled final exam period.

POLICIES FOR ASSIGNMENTS

Late Projects All major projects should be handed in on time according to the due dates on the syllabus. In most cases, this requires you to upload a copy or link to your project to T-Square by 8:00 pm on the due date. Contact me well before the project is due if you believe your situation merits an extension. In most cases, I will ask to speak with you during office hours to figure out a schedule that allows you to complete the assignment without falling behind. In case of an emergency that affects your ability to complete an assignment on time, please let me know as soon as you are able. For every day a major project is late, one-third of a letter grade will be deducted (e.g., from a B+ to a B). After a week, I will no longer accept the assignment, and you will receive a grade of zero for that particular project. For other assignments, such as the blog posts, I will not accept late work. Missed Work Except in the case of the absences that are officially excused by the Institute, students will be unable to make up quizzes, presentations, and in-class assignments. In those instances where the absence is excused, it is the students responsibility to determine what they have missed and to take appropriate measures to make it up. Plagiarism Plagiarism is the representation of anothers words or ideas as your own. It is not only counter to the ethics of the academic culture in which you now participate, but it is also detrimental to the goals of the course, insofar as it does nothing to develop your own skills as a thinker and a communicator. You must give proper credit, according to your chosen citation guidelines, to all words or ideas that are not your own. An instance of academic dishonesty will result in a failure for the assignment and a referral to the Office of Student Integrity, as required by Georgia Tech policy. I encourage you to familiarize yourself with the following sites: - Honor Challenge: http://www.honor.gatech.edu - Office of Student Integrity: http://www.osi.gatech.edu/index.php - Process for Academic Misconduct: http://osi.gatech.edu/plugins/content/index.php?id=15

ASSESSMENT
Evaluation Equivalents
Letter Grade NB: +/- are only for graded assignments. Georgia Tech does not use +/- for course grades. A+ A Superior performance. Rhetorically, aesthetically, and technically, the work demonstrates an advanced understanding and use of the media. It demonstrates both inventive ingenuity and exceptional execution. AB+ B Above-average performance. Rhetorically, aesthetically, and technically, the work is high quality. Numeric Equivalent in this Class 98-100 94-97 90-93 88-89 84-87

Bozio, Syllabus for English 1102

BC+ C CD+ D DF 0

80-83 78-79 Average performance. Rhetorically, aesthetically, and technically, the work is both competent and acceptable. Below-average performance. Rhetorically, aesthetically, and technically, the work is less than competent. Unacceptable performance. This work does not meet the minimum requirements for the assignment. Work not submitted. 74-77 70-73 68-69 64-67 60-63 1-59 0

Rubric
Scale
Rhetorical Awareness. Response to the situation/assignment, considering elements such as purpose, audience, register, and context. Stance and Support. Argument, evidence, and analysis

Basic
Ignores two or more aspects of the situation and thus does not fulfill the task

Beginning
Ignores at least one aspect of the situation and thus compromises effectiveness

Developing
Attempts to respond to all aspects of the situation, but the attempt is insufficient or inappropriate Lacks a unified argument; lacks significance (So what?); lacks sufficient analysis

Competent
Addresses the situation in a complete but perfunctory or predictable way

Mature
Addresses the situation completely, with unexpected insight

Exemplary
Addresses the situation in a complete, sophisticated manner that could advance professional discourse on the topic. Offers an inventive, expert-like position with precise and convincing evidence and analysis Asserts a sophisticated claim by incorporating diverse perspectives that are organized to achieve maximum coherence and momentum Manipulates expectations in ways that advance the argument Persuades with careful, seamless integration of features and content and with innovative use of affordances

Involves an unspecified or confusing argument; lacks appropriate evidence Lacks unity in constituent parts (such as paragraphs); fails to create coherence among constituent parts

Makes an overly general argument; has weak or contradictory evidence

Organization. Structure and coherence, including elements such as introductions and conclusions as well as logical connections within and among paragraphs (or other meaningful chunks)

Conventions. Expectations for grammar, mechanics, style, citation, and genre Design for Medium. Features that use affordances to enhance factors such as usability and comprehensibility

Involves errors that risk making the overall message distorted Lacks the features necessary for genre; neglects significant affordances, such as linking on the web; uses features that conflict with or ignore the argument

Uses insufficient unifying statements (e.g. thesis statements, topic sentences, headings, or forecasting statements); uses few effective connections (e.g., transitions, match cuts, and hyperlinks) Involves a major pattern of errors

Uses some effective unifying claims, but a few are unclear; makes connections weakly or inconsistently, as when claims appear as random lists or when paragraphs topics lack explicit ties to the thesis Involves some distracting errors

Offers a unified, significant, and common position with predictable evidence and analysis States unifying claims with supporting points that relate clearly to the overall argument and employs an effective but mechanical scheme Meets expectations, with minor errors Supports the argument with features that are generally suited to genre and content

Offers a unified, distinct position with compelling evidence and analysis Asserts and sustains a claim that develops progressively and adapts typical organizational schemes for the context, achieving substantive coherence Exceeds expectations in a virtually flawless manner Promotes engagements and supports the argument with features that efficiently use affordances

Omits some important features; involves distracting inconsistencies in features (e.g., type and headings); uses features that dont support argument

Uses features that support argument, but some match imprecisely with content; involves minor omissions or inconsistencies

Bozio, Syllabus for English 1102

WEEKLY SCHEDULE
Readings are to be completed on the day they appear on the syllabus. If the assigned reading is not in one of the required texts, you can find it on WordPress, at 1102Spring2014.WordPress.com. Activities are done in class. Homework should be completed by 8:00 pm the day before we meet in class. Week 1 January 6: Introduction to the Course Homework: Create accounts on WordPress. Accept my invitation to join the WordPress blog. January 8: Spaces of Difference Read: Michel Foucault, Of Other Spaces, trans. Jay Miskowiec. Diacritics 16, no. 1 (Spring 1986): 22-27 [Wordpress] Read: bell hooks, Preface to the First Edition, Feminist Theory: From Margin to Center (Cambridge: South End Press, 2000), xvi-xvii [WordPress] Homework: Read Lows The Gated Community as Heterotopia or listen to This American Lifes House Rules and write your first blog post. Your first blog post is due on January 9 at 8:00 pm. January 10: Geographies of Race Read: Setha Low, The Gated Community as Heterotopia, in Heterotopia and the City: Public Space in a Postcivil Society, eds. Michiel Dehaene and Lieven de Caute (New York: Routledge, 2008), 152-163 [Wordpress] Listen: This American Life, House Rules [WordPress] Week 2 January 13: Hythlodays Mirror of England Read: More, Utopia, 1-21 January 15: The Politics of Nowhere Read: More, Utopia, 21-38 January 17: Utopian Geography Read: More, Utopia, 38-57 Week 3 January 20: No class, MLK Holiday

Bozio, Syllabus for English 1102

January 22: Philosophy in Paradise Read: More, Utopia, 57-77 January 24: Conquest and the Utopian Commonwealth Read: More, Utopia, 77-97 Week 4 January 27: CommLab Presentation, Small Group Workshops Activity: Use the rubric to evaluate and to grade an assignment. January 29: Small Group Workshops January 31: Small Group Workshops Paper due on Sunday, February 2 at 8:00 pm Week 5 February 3: The Politics of Cartography Read: Denis Wood (with John Fels), The Power of Maps (New York: Guilford Press, 1992), 4-27 [Wordpress] Homework: Explore Mapping Early Modern Worlds, Digital Archive at the Folger Shakespeare Library [http://www.folger.edu/template.cfm?cid=1681] and write your second blog post. For your post, select one of the digital atlases and explore it in detail. How do early modern cartographers map a particular environment? What information do they include (or occlude)? And what kinds of judgment does the map seem to make about culture, race, and identity? Your second blog post is due on February 6 at 8:00 pm. February 5: Early Modern Cartography Digital Discussion of Mapping Early Modern Worlds February 7: Reading Day Week 6 February 10: The Scythian Shepherd Read: Marlowe, Tamburlaine Part One, Act 1 Homework: Read Act 2 of Tamburlaine Part One and write your third blog post. Your third blog post is due on February 11 at 8:00 pm.

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February 12: Tamburlaine and the Conquest of Persia Digital Discussion of Tamburlaine Part One, Act 2 February 14: The Fall of the Turkish Empire Read: Marlowe, Tamburlaine Part One, Act 3 Week 7 February 17: Zenocrates Fate Read: Marlowe, Tamburlaine Part One, Act 4 February 19: Tamburlaine Advances upon Damascus Read: Marlowe, Tamburlaine Part One, Act 5 February 21: Library Session on Multimedia Research Proposals for your Cartography Project Due on Sunday, February 23 at 8:00pm Week 8 February 24: Library Session on Using Neatline February 26: Tamburlaine, Father of Three Read: Marlowe, Tamburlaine Part Two, Act 1 February 28: The Death of Zenocrate Read: Marlowe, Tamburlaine Part Two, Act 2 Activity: Midterm Feedback Week 9 March 3: The Fall of Aleppo Read: Marlowe, Tamburlaine Part Two, Act 3 March 5: Slouching Towards Babylon Read: Marlowe, Tamburlaine Part Two, Act 4 March 7: Tamburlaines Map Read: Marlowe, Tamburlaine Part Two, Act 5

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Week 10 March 10: Small Group Workshops March 12: Small Group Workshops March 14: Small Group Workshops Cartography Project due Sunday, March 16 at 8:00pm Week 11 March 17: Spring Break, No Class March 19: Spring Break, No Class March 21: Spring Break, No Class Week 12 March 24: Othello, the Moor of Venice Read: Shakespeare, Othello, Act 1 March 26: Once more, well met at Cyprus Read: Shakespeare, Othello, Act 2 March 28: Ocular Proof Read: Shakespeare, Othello, Act 3 Week 13 March 31: My lord, this would not be believed in Venice Read: Shakespeare, Othello, Act 4 April 2: A Malignant and a Turband Turk Read: Shakespeare, Othello, Act 5 April 4: Othello in Performance Activity: Watch the same scene in three versions of Othello. How does the staging of the scene change its significance? How do things like sound, camera angle, and voice-over change the meaning of whats being performed? Week 14 April 7: Mapping Place: Africa Beyond Paper, Exhibition at the Paper Museum

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Homework: Find a version of Othello on Youtube and analyze a scene from it as your fourth blog post. Your fourth blog post is due on April 8 at 8:00 pm. April 9: Library Session on Using Handbrake April 11: Small Group Workshops Week 15 April 14: Oral Presentations April 16: Oral Presentations April 18: Oral Presentations Week 16 April 21: Week Preceding Final Exam Activity: Revise your Portfolio Activity: Final Evaluations April 23: Week Preceding Final Exam Activity: Revise your Portfolio April 25: Week Preceding Final Exam Activity: Revise your Portfolio Final Exams April 28-May 2

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STATEMENT OF UNDERSTANDING
Please read, sign, and return these statements to me. I affirm that I have read the entire syllabus and policy sheet for ENGL 1102 and understand the information and the responsibilities specified. _____________________________________________ Print Full Name _____________________________________________ Signature _____________________________________________ Date

Read this form carefully, and check all that apply.

! !

I give my instructor, Andrew Bozio, permission to use copies of the work that I do for this course, ENGL 1102, as examples in presentations and in print and electronic publications. I do not want my work used as examples in any situations.

If you give permission for your work to be used, please indicate how you want to be acknowledged:

! !

Please acknowledge me by name. Please use my work, but do not acknowledge me by name.

The following information enables me to contact you if your work is used. _____________________________________________ Print Full Name _____________________________________________ Signature Bozio, Syllabus for English 1102 14

_____________________________________________ _____________________________________________ Permanent Address _____________________________________________ _____________________________________________ Campus Address

_____________________________________________ Phone Number _____________________________________________ Email Address _____________________________________________ Date

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