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    Questionnaire

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    laliberte68
    This document is a chemistry class information form for a student to fill out for Mr. Laliberte. It requests the student's name, nickname, contact information for guardians, activities they are involved in, possible career paths, and any special needs or accommodations. It also includes a short survey for the student to rate their interest in science, math skills, memorization ability, conceptual understanding, and homework completion from the previous year. The form concludes by having the student provide their chemistry textbook information.

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    Questionnaire

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    laliberte68
    27 views1 page
    This document is a chemistry class information form for a student to fill out for Mr. Laliberte. It requests the student's name, nickname, contact information for guardians, activities they are involved in, possible career paths, and any special needs or accommodations. It also includes a short survey for the student to rate their interest in science, math skills, memorization ability, conceptual understanding, and homework completion from the previous year. The form concludes by having the student provide their chemistry textbook information.

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    This document is a chemistry class information form for a student to fill out for Mr. Laliberte. It requests the student's name, nickname, contact information for guardians, activities they are involved in, possible career paths, and any special needs or accommodations. It also includes a short survey for the student to rate their interest in science, math skills, memorization ability, conceptual understanding, and homework completion from the previous year. The form concludes by having the student provide their chemistry textbook information.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    27 views1 page

    Questionnaire

    Uploaded by

    laliberte68
    This document is a chemistry class information form for a student to fill out for Mr. Laliberte. It requests the student's name, nickname, contact information for guardians, activities they are involved in, possible career paths, and any special needs or accommodations. It also includes a short survey for the student to rate their interest in science, math skills, memorization ability, conceptual understanding, and homework completion from the previous year. The form concludes by having the student provide their chemistry textbook information.

    Copyright:

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    Download as DOC, PDF, TXT or read online from Scribd
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    CHEMISTRY: MR.

    LALIBERTE Class Period:

    Name: Nickname:

    Name(s) of Guardians or Parents Relationship Daytime Phone #

    _____________________________________ ______________ __________________

    _____________________________________ ______________ __________________

    What types of activities are you involved in during the school year?

    What possible career paths are you considering for the future?

    Is there anything special that I should know about you? (For example, do you
    need to sit up front? Is there someone in class that you cannot work with?
    504 plan?)

    Indicate how much you agree with these statements by circling the appropriate
    number. Choose [1] for strongly agree, [2] for somewhat agree, [3] for no or
    neutral opinion, [4] for somewhat disagree, and [5] for strongly disagree.

    a) I'm interested in learning explanations about nature. [1] [2] [3] [4] [5]
    b) I want to improve my math and thinking skills. [1] [2] [3] [4] [5]
    c) I am good at memorizing things. [1] [2] [3] [4] [5]
    d) I am good at understanding concepts. [1] [2] [3] [4] [5]
    e) I completed all or nearly all of my homework last year. [1] [2] [3] [4] [5]

    Name of Chemistry Text Book #

    Laliberte, 8/25/08

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