Student Information

Purpose: To collect contact information from each student.


A red asterisk (*) indicates required questions.

  1. What day are you scheduled for this class?*
    A
    B


  1. Enter your Student ID #*


  1. First Name: as it appears in POWER SCHOOL*


  1. Last Name: as it appears in POWER SCHOOL.*


  1. Indicate the class you are enrolled in?  *


  1. Enter the BLOCK # for this class?  *


  1. Provide your address:
    House Number (Apt # if Applicable) then Street Name*


  1. Provide the FIRST Name of an adult who is repsonsible for your care and well being:
    FIRST NAME*


  1. Provide the LAST Name of an adult who is repsonsible for your care and well being:
    LAST NAME*


  1. Provide the Phone Number for this same adult who is responsible for your care and well being:*


  1. Provide YOUR SCHOOL EMAIL ADDRESS: ( gmail)
    *


  1. What grade are you in?*
    12
    11
    10
    9


  1. Did you already take PLTW - Introduction to Engineering and Design*
    YES
    NO
    Do not plan to


  1. Did you already take PLTW - Principles of Engineering*
    YES
    NO
    Do not plan to


  1. Did you already take PLTW - Computer Integrated Manufacturing*
    YES
    NO
    Do not plan to


  1. How do you like to learn new information or learn new tasks?
    1 is the Lowest/Least/Not Liked
    4 is the Highest/Most/Best Liked*

          1 2 3 4    
      Watch someone who knows how...   
      Read about it...   
      Watch someone then try it on your own...   
      Watch someone then have them watch you do the same thing...provide correection on the spot   
      Read about it then have someone watch you try it on your own...   
      Listen to explanations then try it on your own...   
      Have someone show you every little detail...   
      Show me what it will look like at the end...let me figure it out.   
      I need to be "spoonfed" like an infant...I need lots of attention...and kind words   
      Honestly, I'm lazy and don't care much about anything having to do with school.   





Steve Adamczyk