s2013 PLTW (Davis) Student Information Sheet
Name: 


A red asterisk (*) indicates required questions.

  1. Please list your name: Last, First*


  1. Please select the PLTW you are currently enrolled in:*
    3rd Block POE with Mr. Davis
    4th Block POE with Mr.Davis


  1. Enter your street address, Apt. #, City, State and Zip Code. As follows:
    Address
    Apt.
    City, State
    Zip*


  1. Enter your date of birth. Use the format mm/dd/yyyy*


  1. Enter your student identification number.*


  1. Enter YOUR cell phone number with area code. *


  1. What is YOUR email address. (where I can send study guides, makeup work and/or other communications to you.)*


  1. Check ALL the following PLTW (project Lead the Way) Classes you have completed and passed.*
    POE-Principles of Engineering
    CIM- Computer Intergtated Manufacturing
    EDD- Engineering Design & Development
    DE- Digital Electronics
    IED- Introduction to Engineering Design
    CEA- Civil Engineering and Architecture
    None


  1. Check the following software applications you know how to use.*
    MS Word
    MS Excel
    MS PowerPoint
    MS Access
    MS Publisher


  1. What clubs or sports are you involved in at school?*


  1. What are your plans and goals after high school?*


  1. Do you like to work on projects with other people?*
    Yes
    No


  1. How would you rate your self as a student?*
    A B C D F


  1. Check the following Design software applications you know how to use.*
    AutoCAD
    Inventor
    Revit
    None


  1. If an emergency would arise, please the following information:
    Contact persons name:
    Relationship:
    Phone number(s)*


  1. How would you rate yourself using Autodesk Inventor?*
      1 2 3 4 5  
    Excellent   Poor


  1. Is the something you would like Mr. Davis to know about you?


  1. Where and What type of work does your parents/guardians do for a living?*


  1. Enter the name of your mom / guardian.
    *


  1. Enter your mom's / guardian's cell phone number. *


  1. Enter your mom's / guardian's Email address.*


  1. Enter the name of your dad / guardian.*


  1. Enter your dad's / guardian's cell phone number. *


  1. Enter your dad's / guardian's Email address.*


  1. If you have a "nickname" or preferred name to be called in class please list below.





Mr. Davis
School of Math Engineering Technology & Science
Charlotte, NC