#2 - Getting to Know You

Please answer each question accurately.
Name: 


A red asterisk (*) indicates required questions.

  1. Last Name:*


  1. First Name:*


  1. Birth Date: (MM/DD/YY)*


  1. Your Student Number:*


  1. Your Parent/Guardian Name(s):*


  1. Your Home Address:*


  1. Your Home Telephone Number:*


  1. Your Email Address (If you have one):


  1. Do you have a computer at home?*
    Yes
    No


  1. Do you have access to the Internet at home?
    *
    Yes
    No


  1. Do you belong to any social-networking sites?*
    Yes
    No


  1. If you answered 'Yes", choose the social-networking sites you use from the list below.
    Facebook
    My Space
    Twitter
    Friendster
    Bebo
    LinkedIn
    Poptropica
    MyYearbook
    Blackplanet
    MoshiMonsters
    FreeRealms
    other


  1. How often do you visit your social-networking sites?
    Every day
    Two or more days per week
    Once a week
    A few times each month


  1. When you do visit these sites, how much time do you usually spend on them?
    three or more hours
    one hour
    less than an hour


  1. What I like best about myself is .....*


  1. My happiest memory is .....*


  1. In my spare time I like to .....*


  1. My three favorite foods are.....*


  1. My favorite sport is ............ because.......*


  1. I usually pick friends who are.....*


  1. I would like to be better at..... (choose a school subject)*


  1. I don't like it when teachers .........





Mrs. Shaffer
Computer Applications/Business Teacher
West Side Leadership Academy
Gary, IN