2015-2016 DVHS Beginning of Year Physics Survey
Welcome!
Please complete this form and submit it as soon as possible. Your honest and detailed answers will help us to collaborate and contribute to your success in this class. Please read instructions carefully as this survey is formatted to automate data entry. Your responses to this survey will be kept confidential and are solely used for the purposes of instruction and mentoring.
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Today's Date *
MM
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DD
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First Name *
Last Name *
Middle Initial
Name by which you want to be called
(i.e., nickname)
Gender *
In which period do you have Mr. Davis? *
Student ID Number?
(Look on your Student ID. A.k.a. Matriculation number.)
Email Address *
(e.g., Student2967@email.com) Important news and updates will be sent to you over email, so it is imperative that you check your email frequently.
I am a _____________________ at Desert View High School. *
(Select your class from the list below.)
When is your birthday? *
MM
/
DD
/
YYYY
Phone number at which you can be reached. *
(Include area code, but do not use any punctuation, e.g, 5202864952)
Parents' or Guardians' name(s): *
Please include first and last names.
Language spoken (predominantly) at home: *
What other language(s) do you speak?
(Check all that apply.)
What do you do after school or on weekends?
(Check any that apply.)
After High School, I plan on... *
What factors, in your opinion, are the greatest predictors of your success in this class? *
What factors may prevent your success in this class?  (e.g., part-time job after school, math phobic, learning disabilities, chronic procrastination, etc.) *
How can I, the teacher, best insure your interest and success in this class? *
 What unique experience/knowledge/perspective can you bring to this class?  What do you, the student, have to teach me, the teacher? *
Is there anything else you would like me to know about you?
What was the last math course you COMPLETED prior to this course? *
(NOTE: concurrent enrollment of Algebra II or above is REQUIRED.)
What science courses have you COMPLETED prior to this year? *
(Check all that apply.)
Required
The Classroom Rules and Procedures are posted in my classroom, are printed in the class syllabus, and we discussed them the first day of school. If you read, understood and agree to these Rules and Procedures, check 'I Agree' below; otherwise, check 'Other' and provide a response. I will contact you at my earliest convenience to discuss any issues you may have. *
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