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NMSI Student Incentive Survey
You need to fill this out so that if you earn an incentive reward, they have your information. FAILURE TO COMPLETE THIS SURVEY WILL RESULT IN NO REWARD!!!! You need to be very precise, so take care as you fill this out!!!! We need this done ASAP!!!!
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* Indicates required question
What DISTRICT are you from?
*
CENTRAL: Mililani, Leilehua, Radford
LEEWARD: Campbell
Required
What SCHOOL are you from? CHECK ONE!
*
Choose
Campbell High
Leilehua High
Mililani High
Radford High
What is your LAST NAME?
*
Your answer
What is your FIRST NAME?
*
Your answer
What is your ETHNICITY? If you are mixed, go with the one you have the most blood of. CHOOSE ONE!
*
Choose
Caucasian or White
American Indian or Alaska Native
Black or African American
Mexican or Mexican American
Puerto Rican
Other Hispanic, Latino or Latin American
Asian, Asian American or Pacific Islander
What is your Gender?
*
Male
Female
Required
Are you Free or Reduced Lunch Status?
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Free and Reduced Lunch
No, I am not
Required
Are you a MILITARY DEPENDENT?
*
YES, MILITARY DEPENDENT
No, I am NOT a Military Dependent
Required
When is your BIRTHDAY?
*
Your answer
What GRADE are you in right now?
*
Choose
9
10
11
12
Which AP COURSE are you taking? (Course 1)
*
Choose
AP Calculus AB
AP Calculus BC
AP Statistics
AP Chemistry
AP Physics
AP Computer Science
AP Biology
AP Literature and Composition
AP Language and Composition
Other
What is your Course 1's Teacher's LAST NAME?
*
Your answer
What is your Course 1's Teacher's FIRST NAME?
*
Your answer
If Applicable, Which AP COURSE are you also taking? (Course 2)
Check the last choice if this does NOT apply to you!
Choose
AP Calculus AB
AP Calculus BC
AP Statistics
AP Chemistry
AP Physics
AP Computer Science
AP Biology
AP Literature and Composition
AP Language and Composition
I DO NOT HAVE ANOTHER COURSE
What is your Course 2's Teacher's LAST NAME?
Your answer
What is your Course 2's Teacher's FIRST NAME?
Your answer
If Applicable, Which AP COURSE are you also taking? (Course 3)?
Check the last choice if you do NOT have another course!
Choose
AP Calculus AB
AP Calculus BC
AP Statistics
AP Chemistry
AP Physics
AP Computer Science
AP Biology
AP Language and Composition
AP Literature and Composition
NONE I do not have another course
What is your Course 3 Teacher's LAST NAME?
Your answer
What is your Course 3 Teacher's FIRST NAME?
Your answer
If Applicable, Which AP COURSE are you also taking (Course 4)?
Check the last item if you do NOT have another course!
Choose
AP Calculus AB
AP Calculus BC
AP Statistics
AP Chemistry
AP Physics
AP Computer Science
AP Biology
AP Language and Composition
AP Literature and Composition
NONE, I do not have another COURSE
What is your Course 4 Teacher's LAST NAME?
Your answer
What is your Course 4 Teacher's FIRST NAME?
Your answer
What was your PSAT READING score?
*
Your answer
What was your PSAT WRITING score?
*
Your answer
What was your PSAT MATH score?
*
Your answer
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