English III Fall 2011 Student Information



A red asterisk (*) indicates required questions.


  1. Student Name (First + Last)*


  1. Name of Parent(s)/Guardian(s)*


  1. Relationship of above listed contacts (specify mom + dad, mom + stepdad, dad + stepmom, aunt, grandparents, etc.)*


  1. Parent/Guardian Address (House Number + Street)*


  1. Parent/Guardian Address (City, State, Zip)*


  1. Parent/Guardian Home Phone Number (XXX) XXX-XXXX*


  1. Parent Cell Phone Number 1 (XXX) XXX-XXXX
    (specify Mom, Dad, grandmother, etc., in parentheses afterward)*


  1. Parent Cell Phone Number 2 (XXX) XXX-XXXX
    (specify Mom, Dad, grandmother, etc., in parentheses afterward)*


  1. Parent e-mail address 1
    (specify Mom, Dad, grandmother, etc., in parentheses afterward)*


  1. Parent e-mail address 2
    (specify Mom, Dad, grandmother, etc., in parentheses afterward)*


  1. Which of the following items do you have available to you or use on a regular basis? (Select ANY of the following that apply.)*
    Smartphone (iPhone, Blackberry, etc.)
    iPod (either standalone unit or built-in iPhone app)
    iTunes
    iPad
    Laptop Computer at Home
    Desktop Computer at Home
    Internet Access at Home (Dial-up ONLY)
    Internet Access at Home (High-speed: Broadband, Satellite, etc.)
    3G Internet Access on a Device at Home (smartphone, iPod, iPad, Laptop)
    USB/Flash Drive
    Printer


  1. What is the name of your homeroom teacher? (Last name will suffice--unless two MCHS teachers have the same last name.)*


  1. What is your 1st Block Class + Teacher (class name/teacher name).
    If you have a DIFFERENT quarter 2 Class + Teacher, list those as well.*


  1. What is your 2nd Block Class + Teacher (class name/teacher name).
    If you have a DIFFERENT quarter 2 Class + Teacher, list those as well.*


  1. What is your 3rd Block Class + Teacher (class name/teacher name).
    If you have a DIFFERENT quarter 2 Class + Teacher, list those as well.*


  1. What is your 4th Block Class + Teacher (class name/teacher name). If you have a DIFFERENT quarter 2 Class + Teacher, list those as well.*


  1. Tell me who you are in THREE COMPLETE sentences--no more, no less. (Consider this question as if you were answering an ABOUT ME/INFO section on Facebook, etc.)*