2010-2011 Oral Communication Student Information Form

New student survey

Name


A red asterisk (*) indicates required questions.


  1. What is your legal name of record? *


  1. By what name do you want to be "called" in class? My given name is Teresa Sheree, you may call me Mrs. C.*


  1. Please provide me with a home contact name (parent/guardian), phone number, and email if possible. PLEASE give a CORRECT phone number. If I need to call and you've given me a wrong number, it is VERY frustrating. You won't like me when I'm frustrated...*


  1. What is at least one strong area you have when it comes to your communication skills (verbal, nonverbal, listening, speaking, etc.)?*


  1. What is at least one weak area you have when it comes to your communication skills (verbal, nonverbal, listening, speaking, etc.)?*


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


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


  1. Please select all technology you are familiar with using.*
    email
    Microsoft Word
    PowerPoint
    Quia testing
    Movie Maker or Photo Story
    Internet Research
    Podcasts
    Sametime meeting room
    Digital photography
    Web 2.0 applications
    Moodle
    VoiceThread


  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 your high school.*
    Covenant Keepers
    Woodlawn
    Highland
    Guy-Perkins
    Cave City
    Mayflower
    Mountain Pine
    Cross County


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


  1. Please select any formal services you receive at school. This is for my information only, to better help you in class.*
    IEP
    504
    ESL
    other
    NONE


  1. If you answered "other" above, please explain for me.