Getting to Know You Survey
Hello, students! After you have read our course syllabus, please take a few moments to complete this form. Your responses will come directly to me and will be kept confidential. I will use the information you provide to support your success this semester. Thanks so much for your time!

Required questions are marked with an asterisk (*).

This survey by Michelle Pacansky-Brock is shared in the Public Domain, which means you are free to re-use and adapt it as you'd like without attribution.
Sign in to Google to save your progress. Learn more
First Name *
What would you like me to call you?
Last Name *
Your Pronouns *
Which of the following describes you? *
Select all that apply.
I may leave you feedback in voice or video this semester. How does that sound to you? *
In one word, describe how you are feeling about this class. *
What is the one thing that is most likely to interfere with your success in this class? *
At this time, what is your academic goal? *
What is one characteristic of a great online class? *
Is there anything you'd like to share or ask me at this point?
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.