Student Info Form

Name First Last

I have access to a computer with high speed internet access

Always Sometimes Rarely

I have an email account

Yes No

I LIKE these subject OR I think I do WELL in these subjects (check all that apply)

Math Reading Writing Science Social Studies Music Drama Art Physical Education

I DO NOT LIKE these subjects OR I think I do POORLY in these subjects (check all that apply)

Math Reading Writing Science Social Studies Music Drama Art Physical Education

I own one of these devices and am able to bring it to school

iPod touch iPhone Blackberry Other Cell phone with video capabilities Laptop or Mini-Laptop (netbook) Mp3 device with video capabilities

Check all that apply

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