f2013 PLTW (Davis) Student Information Sheet

Complete all information. Be honest in your answers this information will be used to assess your skills and develop instruction for the year. Enter your first name and last name before starting. Be sure to hit submit upon completion.
Name: 


A red asterisk (*) indicates required questions.

  1. Please select the PLTW you are currently enrolled in:*
    1st Block POE with Mr. Davis
    2nd Block POE with Mr.Davis
    4th Block CIM 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 00/00/0000*


  1. Enter your student identification number.*


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


  1. Enter the names of your parents/guardians.
    Mom:
    Dad:*


  1. Enter your parents/guardians cell phone numbers.
    Mom:
    Dad:*


  1. Enter your parents/guardians home phone numbers.
    Mom:
    Dad:*


  1. Enter your parents/guardians email address.
    Mom:
    Dad:*


  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
    Drafting


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





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