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Welcome to our class. Help me get acquainted with you by completing this online questionnaire. Knowing a bit of background information makes our class friendlier and helps me remember "faces" on the Internet.

If you wish to leave any response blank, you may do so. Your answers will assist me in individualizing the course to meet your professional goals.

I am enrolling in the...

September class
November class
January class
March class
June class
July class

About You

First Name:
Last Name:
Email Address:
Home City:
Home State/Country:

Do you have a second email address you also want to use for this course? If yes, what is it?



About Your Work

Job Title

Classroom Teacher
Specialist
Administrator
Technology coordinator and/or librarian
Office personnel
Other, please specify:

Grade Level(s) you teach:


Subject area or speciality
(For elementary teachers who teach everything, list "elementary".)

Years in teaching?
1-5
6-10
11-15
More than 15 years in education

School name


Location of school (city, state/country)


Grades encompassed in your school
K-12
K-5
K-6
K-8
6-9
6-8
7-9
9-12
10-12
Other, please specify:

About your computer connection and your computer experience

Where will you connect to complete assignments for this course?

Home
School
Both
Other, please specify:

Connection Speed
Dialup Modem
Cable
Wireless
T-1 Line
No idea

My computer is
Windows-based PC
Mac

Rate your comfort level with computers in general
Confident and experienced
Feel competent most of the time
OK, sometimes nervous
Like a complete novice, I avoid the computer

How long have you been using the Internet?
1-6 months
7-12 months
1-2 years
2 years or more

When it comes to using e-mail, I...
Am able to send messages to multiple people
Am able to attach documents to my e-mail
Know how to open attachments
Know how to save as text and attach
Know how to save a document as a "rich text format" (rtf) and attach to an e-mail
Participate in at least one educational listserv
Have used e-mail to communicate with friends and family
Contact experts or collaborate with other classrooms
Communicate with colleagues and parents
Know how to cut and paste
Feel that email is an integral part of my life

Describe your primary Internet usage in the past.
Mostly e-mail
Web surfing
Searching for information
Continuing Education Courses

What, if any experience do you have using Web page design software, such as Dreamweaver, Microsoft FrontPage, Adobe PageMill, Adobe GoLive or Claris HomePage? List any other Web page design workshops or training that you have completed or the URL of any pages that you have developed in the past.


How many computers are available for student use in your classroom?


How many computers in your classroom have Internet access?


If your classroom does not have access to the Internet, how/where can your students access the Internet?


Provide a little background information about yourself, what you are currently doing and why you want to take this class. Tell me briefly about your professional position and background – and something that will help me "remember" you (a unique interest or bit of information about yourself).


Do you have any questions you would like answered before you begin? If yes, please send me your questions in this response box.

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