Please return to Ms. Lehman no later than Friday, August 29st. Please be sure to fill out the back as well.

STUDENT’S FULL NAME: ______

PERIOD: ______BIRTHDAY: ______

ID: ______School:______

EMAIL ADDRESS: ______

FATHER’S NAME: ______

HOME ADDRESS: ______

______

HOME PHONE #: ______

WORK PHONE #: ______EXT: ______MAY I CALL YOU AT WORK? ______

EMAIL ADDRESS: ______

Please provide your email addresses – I will add them to a database and send updates for class information, deadlines, etc.

MOTHER’S NAME: ______

HOME ADDRESS: ______

______

HOME PHONE #: ______

WORK PHONE #: ______EXT: ______MAY I CALL YOU AT WORK? ______

EMAIL ADDRESS: ______

CLASS SCHEDULE:

1st – Teacher: ______

Class: ______

Room #: ______

2nd – Teacher: ______

Class: ______

Room #: ______

3rd – Teacher: ______

Class: ______

Room #: ______

4th – Teacher: ______

Class: ______

Room #: ______

5th – Teacher: ______

Class: ______

Room #: ______

6th – Teacher: ______

Class: ______

Room #: ______

7th – Teacher: ______

Class: ______

Room #: ______

8th – Teacher: ______

Class: ______

Room #: ______

Do you have access to a device with Internet access in my class? ______

If so, do you bring this device daily? ______

Do you have access to a computer at home? ______

If so, does this computer have Internet access? ______

INFORMATION ABOUT YOU:

Do you work? If so where and how many hours a week?

______

Do you participate in extra curricular activities? If so what and for which school?

______

Do you have any learning disabilities?

______

Have you ever failed a Social Studies class? If so, why?

______

What makes History classes easy/hard for you?

______

How do you learn best (visual, auditory, location in class, etc)?

______

What do I need know to maximize your learning and motivation in my class?

______

______

What are you most interested in learning in history?

______

______

Is there anything else you would like me to know about you (hobbies, random facts, favorite music/movies, etc.)?

______

______

Who is your favorite teacher in the building and why?

______

How many AP exams have you taken before? ______

What was your highest score and on which test?

______

What was your lowest score and on which test?

______

Do you have a good place to study and do homework? If no, would you like to use my classroom?

______