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Student Information
Last name, First name *
Your answer
Block *
Parent 1 Name (First and Last) *
Your answer
Parent 1 Cell Phone Number *
Your answer
Parent 2 Name (First and Last)
Your answer
Parent 2 Cell Phone Number
Your answer
Primary Parent Email address *
Your answer
Student School Email *
Your answer
Do you have your own graphing calculator? *
Do you have a phone that an access the internet? *
Do you have access to the internet at home? *
Do you have a job outside of school? *
If you answered "Yes" to having a job, where do you work?
Your answer
Are you involved in any activities at school such as clubs or sports? *
If yes to the previous question, what organizations/clubs are you in?
Your answer
Who was your last math teacher? *
How would you rank your mathmatical ability? *
Struggles
Strong
If you are ever struggling with a topic in math what is your typical response? (Check all that apply) *
Required
What is one thing that you are scared/worried about this semester for math? *
Your answer
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