_________________________________________

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)?