Class Survey

What do you want me to call you: _______________________              current grade level (i.e. 9 - 12):  ______

Do you have a computer at home ? _____             Do you have Internet access from home ? _____   

List your most recent math and science course, semester grades (A - F), and teacher's name:

Math course name: __________________	semester grades: ________	teacher:  ____________
Science course name:  ________________	semester grades:  ________	teacher:  _____________

comments; e.g. Why are you taking this class ? 

List your class schedule: include period, class, teacher, and room number: