____________________________________________

LAST NAME, FIRST NAME

Semester: ____________________ Phone: _____________________________

Class: ____________________ Email: _____________________________

Place a photo

of yourself here.

(worth 5 bonus

points)

Due: 2nd class

1. What was the last English class that you’ve taken? ________________________________

2. Did you place into English 100? (circle one) YES NO

3. Is English your second language? (circle one) YES NO

If yes, what is your first language? ___________________________________________

4. Are you comfortable using the English language (circle one) YES NO

If no, what causes you the most discomfort? ____________________________________

5. What high school did you attend & when did you graduate? ___________________________

6. Is this your first semester in college? (circle one) YES NO

If no, how much college experience have you had?

______________________________________________________________________________

7. How many credits are you taking this semester? ________

8. Do you have a job this semester? (circle one) YES NO

If yes, approximately how many hours a week will you be working? ________

9. Do you have any other responsibilities that might distract you from your studies this semester? (circle one) YES NO

If yes, explain.___________________________________________________________

10. What is the best way for you to learn new information? (rank in order; 1= best)

Visual ________ Auditory ________ Kinesthetic ________

11. What are your educational and career goals?

12. What are your talents and strengths?

13. What are your hobbies and interests?

14. What are your three favorite books or movies?

15. What do you think about history?

16. Have you had any travel experience? If so, where?

17. Why are you taking this particular class (i.e. subject, time, instructor)?

18. Is there anything else that you’d like to tell me about yourself (i.e. ethnicity, family, religion)?