MTH 654/659 questionnaire

Please fill out online the following questionnaire. It will help me to determine the class' background and to decide on the right level/flavor of assignments. Please choose all answers that apply or fill in your information if nothing applies.
It is perfectly fine if you do not know the topics/techniques listed, that is what the class is for: I just need to know the class level.
The big boxes at the bottom can be used for all the extra/unusual information, or you can send me a separate email.