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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