Engineering Design and Development

2011Pre-training Experience Survey

The Project Lead The Way® Core Training (CT) brings together classroom teachers from various subject areas and with varying levels of experience. In order to help your CT instructors prepare to effectively teach to a diverse audience we ask that you take a few moments to complete the following pre-assessment tool. Your responses will only be shared with your CT instructor. Please return the completed form to the Affiliate Director prior to your arrival at the CT. If you do not return the form prior to the CT, you will have to complete the form as part of the onsite registration process.

Date of the CT you will be attending: ______

Name: ______

School: ______

City: ______State:______

Subject(s) taught: ______

List all software used: ______

Number of years teaching: _____

This information below will be used to help shape the dynamics of the groups being formed by the Master Teacher(s) and Affiliate Professor(s). Please note that this information will not be used for any other purpose than this class.

Educational Background & Major: ______

______

Work Experience Outside the Teaching Profession: ______

Circle the PLTW course(s) you are trained to teach:

GTTIEDPOEDECIMCEAAERO BE

Circle the PLTW course(s) you currently teach:

GTTIEDPOEDECIMCEA AERO BE

List the other Technology, Science or Math courses you teach:

______

______

Do you have any of these design skills?

  • Sketching……………………………………Yes No
  • Drafting…………………………………….Yes No
  • CAD
  • AutoCAD…………………………….Yes No
  • Mechanical Desktop…………………Yes No
  • Inventor………………………………Yes No
  • Revit………………………………… Yes No
  • CircuitMaker / Mulitsim……………. Yes No
  • Other ______

Using the scale 0-5 (0 being no skill and 5 being you have the greatest confidence in your skill) rate the following:

Your ability to use machine tools. (ie. lathe, mill, table saw, etc.)

0 1 2 3 4 5

Your ability to use hand tools. (ie. Drill, sander, saw, etc.)

0 1 2 3 4 5

Knowledge and skill using word processing applications.

0 1 2 3 4 5

Knowledge and skill using PowerPoint.

0 1 2 3 4 5

Knowledge and skill researching on the Internet.

0 1 2 3 4 5

Knowledge and skill using digital imaging applications.

0 1 2 3 4 5

Other Pertinent Information

Do you work well with others? Yes No

Will you have access to a vehicle at the STI? Yes No

List equipment you have brought with you to this STI ( i.e. digital camera, jump drive, plasma cutter, etc.) ______

______

I hereby give my permission for my picture to be taken and used solely for the purpose described above.

Name (print) ______

Signature______Date ______

Please use the back of this sheet to identify what you wish to gain from taking this training. Also note any special needs or concerns you may have. Thank You!

Page 1 of 2