\documentclass[12pt,twoside]{article}

\usepackage{xspace}

\newcommand{\coursenumber}{CS 6104}
\newcommand{\coursetitle}{Symbolic Computation}
\renewcommand{\docdate}{May 20, 1996}
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% Some new macros

\newcommand{\Grobner}{Gr\"obner\xspace}
\newcommand{\Mathematica}{\emph{Mathematica\/}\xspace}

\begin{document}

\firstpageheading{50pt}

\thispagestyle{empty}

\begin{center}
\Large\bf\doctitle\\
\smallskip
\Large\bf First Summer Session, 1996\\
\end{center}

Please help me to set up the course by answering these questions.
Feel free to elaborate upon your answers where appropriate.

\vspace*{30pt}

\bf

Your name:

\vspace*{20pt}

What you prefer to be called:

\vspace*{20pt}

Your email address (not optional):

\vspace*{20pt}

World-Wide Web (WWW) experience (0=none, 5=extensive):

\vspace*{20pt}

Home page URL (if any):

\vspace*{20pt}

Major/field:

\vspace*{20pt}

Computer Science background (degrees, courses, programming experience,
computer use, etc.):

\vspace*{120pt}

Mathematics background (degrees, courses, etc.):

\vspace*{100pt}

\newpage

English technical writing skill (1=weak, 3=good, 5=excellent):

\vspace*{30pt}

\LaTeX\ competency (0=none, 5=extensive):

\vspace*{30pt}

\Mathematica competency (0=none, 5=extensive):

\vspace*{30pt}

Do you have access to \Mathematica?

\vspace*{20pt}

Do you have access to the Larch prover (LP)?

\vspace*{20pt}

Are there any other symbolic computation systems you would like to use
and have access to?

\vspace*{50pt}

Is there someone you prefer to work with?

\vspace*{30pt}

Your interest and background in symbolic computation:

\vspace*{100pt}

Any project ideas?

\vspace*{100pt}

\end{document}
