Mr. K's Information Orm-Fay!
Thank you for visiting my information form! Your online responses represent confidential information; they will not be disclosed to any third party and are used only to initiate and maintain contact regarding your child's progress during the current school year.
Thank you for "going green" and saving paper!!
Parents: your completed entry, by Monday, September 16th, 2016, will earn your child a free HOMEWORK PASS- good for any assignment during the 1st 9 weeks!
Type your child's name here!
What does your child prefer to be called?
Prefer not to answer
Which block does your child have his/her math class?
If you do not know, you can leave this blank.
Type your name!
Phone Number #2:
When is the best time of day to reach a parent/guardian by phone?
You may click more than one possible timeframe.
After 8:00 p.m.
I can be reach at any reasonable time of day.
Alternate Email Address:
What is your child's birthday?
(Use the format mm/dd/yyyy)
Does your child have any allergies?
Currently, my child has no known allergies.
My child has an allergy (or allergies) that require no in-school medical intervention.
My child has an allergy that requires in-school medical intervention, and is documented in the JYMS clinic.
Which answer best describes your child's understanding and desire to learn mathematics?
(Don't worry; you can ask them...)
I love math. I dream in order of operations.
I can walk the walk, talk the talk, but I don't "love" it.
I treat math like a rocket launch; respectful awe, with a complete ignorance of the detail involved.
When I hear the word "math", I want to throw things.
Which answer best describes YOUR understanding and ease of understanding mathematics?
(Just as I help children with math, I am happy to help YOU!)
I love math. I use it everyday and try to help my child whenever applicable.
I have an appreciation for math; I can help my child if he/she needs it.
It has been a while, if you know what I mean.
When I hear the word math, I want to phone my old math teachers and say mean things.
Please feel free to use this space to tell us anything you'd like us to know about your child.
(Interests, hobbies, relevant home and/or custody information, comfort level with technology use, information that may better help/educate your child, etc.)
Your child has received, or will receive, a class syllabus sheet containing a wealth of information related to how Mr. Kubinak will conduct class. This information includes, but is not limited to, grading policies, rules/procedures, school supplies, schedules, and my contact information. Your child will keep a copy of this syllabus in their binder for future review. Please click below that you have read and understood that information.
I have read the class syllabus and agree to the policies and procedures presented.
I have read the class syllabus and would like to contact you regarding your policies and/or procedures.
I have not read the class syllabus, but I understand the syllabus is a comprehensive listing of class policies and procedures that will be used and enforced for the entire school year.
At various points during a week or learning unit, your child will utilize an Internet connection to access math resources (videos, mini-lessons, etc.). Many students will endeavor to complete such tasks outside of school, but it is clearly understood that some students may not be able to complete tasks due to a variety of factors. To that end, ALL STUDENTS WILL HAVE EQUAL OPPORTUNITY to utilize resources, whether in- or out-of-school, to complete web-related tasks, in a way that is respectful and meaningful.
Please select one answer.
I understand the foregoing statement.
I understand the foregoing statement, but I will contact your directly for more information.
I have questions regarding this policy, and will contact you at my earliest convenience.
Apart from regularly-planned classroom activities, students will use technology resources to accomplish math-related tasks including but not limited to, tablet PCs, laptop computers, and video recording hardware. When appropriate, students will have the ability to use their own electronic devices to accomplish class tasks. ANY STUDENT WHO BRINGS IN THEIR OWN ELECTRONIC DEVICE FOR SANCTIONED ACTIVITIES IS RESPONSIBLE FOR THE SAFEKEEPING OF THAT DEVICE, AND IN NO WAY WILL A TEACHER, SCHOOL, OR DISTRICT BE LIABLE IN THE EVENT OF LOSS, DAMAGE, AND/OR DESTRUCTION OF PERSONAL DEVICES.
Please select a response of acknowledgement.
I acknowledge the policies stated in the passage above.
I acknowledge the policies stated in the passage above; I will contact Mr. Kubinak at my convenience to discuss the issue further.
I wish to discuss the policy stated above; I will contact you via email, phone or through your website.
At various points in the year, Mr. Kubinak may record lessons, activities, and/or take photographs during class. These media are collected for lesson plan reflection, and/or possible use in grant proposals. Students are not mentioned by name in these recordings. If you would prefer your child not be recorded, please select the statement below that fits that decision.
Please select one answer.
I allow my student to be recorded to educational purposes.
I allow my student to be recorded for educational purposes, but I will contact you to discuss the matter further.
I do not allow my student to be recorded for educational purposes.
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of Suffolk Public Schools.
Terms of Service