Student Information Sheet

Information provided will in no way affect your grade in this course.

Name: ___________________________________ Student #__________
Counselor: _________________________

Home School _________

Asst. Principal __________________________________

Home Address: ______________________________

City: _____________ Zip Code: __________

Home Phone Number: _________________________ I LIVE WITH: BOTH PARENTS

MOM

DAD

My E-mail Address: _________________________________________________________________

Parent/Guardian Contact Information
Mothers Name: __________________________

Phone Number: ___________________________

Place of Employment: ______________________ Work Phone: _____________________________

Fathers Name: ___________________________ Phone Number: ___________________________
Place of Employment: ______________________ Work Phone: _____________________________
Do you have access to the Internet at home? _____
What word processing program do you use? ______________
My favorite subject in school is (no fair saying lunch) _____________________________________
What, if any, student organizations are you involved in at PCEP? _____________________________
_________________________________________________________________________________
My favorite teacher was ________________ at__________________________________________.
I liked him/her because _____________________________________________________________
Would you rather do a creative project or write a paper? ___________________________________
True or False: I Like to Read.

Which do you enjoy more: Fiction

or

Non-Fiction

In the past, have you enjoyed your Social Studies classes? ________ Why or why not? ___________
_________________________________________________________________________________
Do you have any problems with English that I need to know about? For example, are you a horrible
speller? Are you an ESL student? ______________________________________________________
Is there anything that you hope to learn in this class? If so, please explain._____________________
_________________________________________________________________________________
Tell me three interesting or unique things about yourself that will help me to know you better as a
student and a person.
1) _______________________________________________________________________________
2) _______________________________________________________________________________
3) _______________________________________________________________________________
(Revised 09-05)