Introduce Yourself Form - Teaching with Technology

Welcome to our class. Help me get acquainted with you by completing this online questionnaire. Knowing a bit of background information makes our class friendlier and helps me remember "faces" on the Internet.

If you wish to leave any response blank, you may do so. Your answers will assist me in individualizing the course to meet your professional goals.

About You

First Name:
Last Name:
Email Address:
Home City:
Home State/Country:
Do you have a second email address you also want to use for this course? If yes, what is it?

About Your Background

Educational Degrees

Teacher training: Please describe any training (and its duration) you have received since earning your degree (if this is extensive, just note the most recent courses or workshops).

Have you ever taken an online class?

Yes
No

What online classes have you successfully completed? Please note class titles or subject matter.

What online classes did you not successfully complete? Please note class title or subject matter and reasons for not successfully completing it.

About Your Work

Job Title

Classroom Teacher
Specialist
Administrator
Technology coordinator
Media specialist
Other, please specify:

Years in teaching?

Grade Level(s) and subject area or specialty you teach

School name

Location of school (city, state/country)

Grades encompassed in your school

K-12
K-5
K-6
K-8
6-9
6-8
7-9
9-12
10-12
Other, please specify:

About Your Computer Connection and Your Computer Experience

Where will you connect to complete assignments for this course?

Home
School
Both
Other, please specify:

Connection Speed

28K modem
56K modem
DSL
Wireless
T-1 Line
I have no idea

My computer is

Windows-based PC
Mac

Rate your comfort level with computers in general

Confident and experienced
Feel competent most of the time
OK, sometimes nervous
Like a complete novice, I avoid the computer

When it comes to using e-mail, I...

Feel like a total novice
Communicate with friends and family
Participate in educational listservs
Contact experts or collaborate with other classrooms
Communicate with colleagues and parents
Know how to cut & paste
Know how to open attachments
It's an integral part of my life

Describe your primary Internet usage in the past.

Mostly e-mail
Web surfing
Searching for information
Continuing Education Courses

Provide a little background information about your current teaching or training assignment and what you would like to learn in this online workshop.