2010-2011 APLAC Information Form

Name


A red asterisk (*) indicates required questions.


  1. What is your name of legal record?*


  1. What name would you like to be "called" in class? For example, my name is Teresa Sheree and you may call me Mrs. C.*


  1. In what extra-curricular activities are you involved? As you make your list here, do you realize this class (to prepare properly and be most successful) will take AT LEAST THREE TO FOUR HOURS A WEEK AWAY from your other activites?*


  1. What movie, song or phrase best describes you and why?*


  1. Do you plan on attending college? If yes, where?*


  1. Please tell me some things about you that will help us work well together. For example, I have a weird thing with noises and don't work well with a lot of noise going on.
    *


  1. Please select all technology you are familiar with using.
    *
    email
    Microsoft Word
    Power Point
    Movie Maker or Photo Story
    podcasting
    Web 2.0 applications
    Quia
    Internet Research
    Sametime Meeting Room
    Digital photography
    VoiceThread
    Moodle


  1. Please provide me with a home contact name (parent/guardian), phone number, and email if possible. PLEASE give me CORRECT contact information.*


  1. What is your strongest area when it comes to reading, writing, and speaking? Be specific.*


  1. What is your weakest area when it comes to reading, writing, and speaking? Be specific.*


  1. Please select your race (this is for state demographics purposes only)*
    Caucasian
    Hispanic
    African Amer
    Asian - Amer
    Native Amer
    Other


  1. Please select your gender (this is for state demographics purposes only).*
    male
    female


  1. Please select your high school*
    Cutter-Morning Star
    Guy-Perkins
    Mt. Pine
    Hughes
    Pangburn
    Jasper
    Kingston


  1. What is your 1) school mascot, 2) school colors, 3) biggest school rival?*


  1. Your turn...ask me a few questions (be appropriate).*


  1. Please give me your student ID number, otherwise known as your APSCN number. If you do not know it, ask your facilitator now.