Connect Application for Roberts Middle School 2017-2018
Roberts Middle School Connect Application
Student ID Number
Parent Email Address - will be used to notify you if your student is/is not accepted into the program
What school do you currently attend?
South Belt Elementary
What is your preferred method of working and producing work?
Paper and Pencil
Worksheets and textbooks
When working on the computer, how much do you like working on the computer?
I like doing all work on the computer.
I like doing some work on the computer.
I like to get on the computer every other day
I do not like working on the computer.
When working independently, as a learner I need:
Constant reminders to stay on task.
A few reminders to stay on task.
No reminders to stay on task.
In your experience, when a teacher is teaching a lesson, you feel most like: (Check all that apply)
The teacher goes too fast.
The teacher goes to slow and I get bored
I am right on target with the teacher.
I have trouble staying focused.
How often do you read?
I only read at school
I read every chance I get.
I read when I'm really interested in something.
I do not like to read.
When I read, most of my reading is done at:
Home and School
I do not like to read
How do you feel about group work?
I enjoy group work.
I enjoy group work from time to time.
I prefer to work independently.
What role do you play in group work?
I enjoy taking the lead.
make sure we are all contributing equally.
I depend on others to complete the work.
Others depend on me to complete the work
How do you feel about your education? (Check all that apply)
I think school is key to being successful in life.
I think school is pointless.
I think school is necessary, but I do not enjoy it.
I think school could be more enjoyable if I had more say in my education.
I think school is great just the way it is.
How far do you see yourself going with your education?
I would like to graduate high school.
I would like to graduate high school and know what I want to study in college.
I would like to attend a year or 2 of college or university.
I would like to graduate from a university.
Who is responsible for you being a successful student?
It is a combined effort
On a regular school day, do you find that your teacher:
Constantly has to correct your behavior.
Sometimes has to correct your behavior.
Rarely has to correct your behavior
I have never gotten in trouble at school.
How often are you absent from school?
I miss about once a week.
I miss about once a month.
I miss a few days per school year.
I usually have perfect attendance.
Why do you want to be a part of the Connect Program?
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