4TH Hour Who Are You
Please fill in the following to provide me with a better understanding of who you are.
First Name
Your answer
Last Name
Your answer
Do you have food allergies?
Do you have any allergies requiring you to carry an EpiPen?
If yes, what is the allergy?
Your answer
Month of Birth
Your answer
Date of Birth
Your answer
Year of Birth
Your answer
Check the boxes that apply to you
Required
If a parent or sibling has passed away, use the space below to tell who passed away and when.
Your answer
If you have a unique living situation and wanted to explain further use the space below
Your answer
If I need to call home, who would you prefer I try to contact first and why?
Your answer
How do you get to school?
Required
Check boxes of school activities you will participate in this school year
Required
Now list all school activities that you already have participated in and will continue to participate in this school year
Your answer
Check boxes of out of school activities that you participate in
Required
List any clubs or sports that your have NOT participated in school, but you are INTERESTED in joining this school year.
Your answer
What is your favorite school subject?
Your answer
Why is this your favorite subject?
Your answer
What is your least favorite subject?
Your answer
Why is this your least favorite subject?
Your answer
If you have a learning disability, please describe the disability and how this effects you in the classroom
Your answer
What is your definition of a fair teacher?
Your answer
Use the space below to tell me anything else about you that I should know.
Your answer
Check the boxes that apply to you
Required
If you have a Twitter account what is your name on it...mine is @differNtiated4u
Your answer
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