Mr. O'Brien's Student Information 2011-12

1. Please provide the contact information below:
*This question is required.

First name:
Last name:
Your email address:
Parent email address:
Best contact phone number:

2. What math class are you in this year? *This question is required.

3. What grade are you in? *This question is required.

4. Who is your counselor? *This question is required.

5. Take a look at your schedule. When is your study hall and who is the teacher? (e.g. Red 2 Ithomitis) If you have more than one study all, please list them all.

6. Will you have internet access at home?
*This question is required.

The better I know you, the better I can teach you mathematics. Answering the following will tell me a little about your experience learning mathematics thus far.

7. Which of the following best describes your success with mathematics? *This question is required.

8. Which of the following best describes your feelings about mathematics? *This question is required.

9. My grade last year in math was: *This question is required.

10. The grade I hope to get this year in math is: *This question is required.

11. Is there anything else you'd like to tell me- other interests, extra email addresses, things that would help me teach you better, etc?

Mr. O'Brien's Student Information 2011-12

Page One