Request edit access
Personal Goals and Influences
Welcome.  This is an opportunity for me to learn about you, your goals and what you
want from this course.   It also helps me to learn of any challenges that you think I should know about so that I can help you succeed.  (This is ungraded.)
Sign in to Google to save your progress. Learn more
Name (and nickname if you have one that you would like me to use). *
Home Town *
Major *
How many units are you taking this semester?
When do you plan to graduate *
Are there any technical issues that you need help to address in order to be successful with this class in its on-line format?
Do you have any specific personal goals for this class? *
Would you like any accommodation based on a disability?  If so, please describe how I can help or arrange to speak with me privately if that is more comfortable. *
Are there any personal matters that you would like me to be aware of? *
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of CSU, Chico. Report Abuse
Google Forms