2019-2020 CEMS Distance Learning Application
Please complete the following application to register for a distance learning foreign language class during the up-coming school year. The guidance department at your school will notify you of your enrollment status.
Email address *
STUDENT LAST NAME: *
STUDENT FIRST NAME: *
DATE OF BIRTH: *
Power School Number *
Student E-mail Address *
Next school year (2019-2020) I plan to attend _____. *
Grade Level for 2019-2020 *
Parent/Guardian Name: *
Parent's Daytime Telephone Number *
Parent Email Address
Course Selection: *
SELECT ONE from the list of course offered at middle school.
Student Questionnaire
This following questionnaire should be completed by the student.
Who is most responsible for what and how much you learn? *
Which statement best describes your personal motivation and self-discipline? *
Which best describes your problem-solving skills? *
Which describes the ways you communicate with family, friends, and others? *
Which statement best describes your ability to plan, prioritize tasks and organize assignments? *
I submit my assignments on time. *
Which statement best describes your interest in taking an online course? *
Which statement best describes your reading ability? *
Which statement best describes your computer skills? *
Which of the following methods of instructor feedback do you prefer? *
When you have a question, how quickly do you feel you need a response from your instructor? *
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This form was created inside of Harnett County Schools.