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ES 21 Entry Survey Fall 2016

Basic Information and Interests

1. Basic information *This question is required.

First name
Last name
Concentration/Degree Program (if undergrad undecided, write \'intended in X\' or \'undecided\')
Grade level in your program
Graduation year

2. Your preferred email (please double-check as we'll use this for first week communications) This question requires a valid email address.

3. How comfortable do you feel with each of the following: *This question is required.

Space Cell	Not comfortable at all	Somewhat comfortable	Comfortable	Extremely comfortable
Working with behavior-based design concepts	Working with behavior-based design concepts: Not comfortable at all	Working with behavior-based design concepts: Somewhat comfortable	Working with behavior-based design concepts: Comfortable	Working with behavior-based design concepts: Extremely comfortable
Working in a design/prototyping studio environment	Working in a design/prototyping studio environment: Not comfortable at all	Working in a design/prototyping studio environment: Somewhat comfortable	Working in a design/prototyping studio environment: Comfortable	Working in a design/prototyping studio environment: Extremely comfortable
Working on a problem that I have no idea how to approach	Working on a problem that I have no idea how to approach: Not comfortable at all	Working on a problem that I have no idea how to approach: Somewhat comfortable	Working on a problem that I have no idea how to approach: Comfortable	Working on a problem that I have no idea how to approach: Extremely comfortable
Creating an idea for a project that will impact the world	Creating an idea for a project that will impact the world: Not comfortable at all	Creating an idea for a project that will impact the world: Somewhat comfortable	Creating an idea for a project that will impact the world: Comfortable	Creating an idea for a project that will impact the world: Extremely comfortable
Working with others on a team	Working with others on a team: Not comfortable at all	Working with others on a team: Somewhat comfortable	Working with others on a team: Comfortable	Working with others on a team: Extremely comfortable
Working with people whose ideas are very different from my own	Working with people whose ideas are very different from my own: Not comfortable at all	Working with people whose ideas are very different from my own: Somewhat comfortable	Working with people whose ideas are very different from my own: Comfortable	Working with people whose ideas are very different from my own: Extremely comfortable
Taking on a leadership role in a group	Taking on a leadership role in a group: Not comfortable at all	Taking on a leadership role in a group: Somewhat comfortable	Taking on a leadership role in a group: Comfortable	Taking on a leadership role in a group: Extremely comfortable
Planning a large project	Planning a large project: Not comfortable at all	Planning a large project: Somewhat comfortable	Planning a large project: Comfortable	Planning a large project: Extremely comfortable
Presenting my work in public	Presenting my work in public: Not comfortable at all	Presenting my work in public: Somewhat comfortable	Presenting my work in public: Comfortable	Presenting my work in public: Extremely comfortable

4. What do you want to learn in the Innovators' Practice and why do you think you are a good fit for a class like this?

5. Do you have specific ideas that you'd like to explore or develop in this class? If so, please describe in few words.