PFS! Computer Science

Student Information Form

It is helpful for me, as your instructor, to have access to certain information about you, mostly contact information so that I can reach you or your parent/guardian(s) outside of school hours. Before entering any personal information here, please verify that this is a secure form by looking for the padlock icon in your browser. I appreciate the time and effort you put into filling it out, and am happy to offer you a nominal amount of extra credit as thanks for completing this initial "assignment."

This form should take no more than 5 minutes or so to fill out. When you've finished, be sure to hit the "Submit" button at the bottom.


Personal Info

1. Which of Mr. White's PFS sections are you enrolled in?

2. Your first name

3. Your last name

4. Any other name or nickname that you prefer to called by

5. A "codename" that you make up for accessing your assignments grades ("go ME!", "supersuper", or "#37!", for example)

6. Your e-mail address

7. Your phone number

8. Your mailing address (including number, street, city, zipcode)

9. I have read the Academic Integrity section and agree to abide by it.

Parent/Guardian Info

10. Parent/Guardian #1's first name

11. Parent/Guardian #1's last name

12. This person is your:
     Mother
     Father
     Stepmother
     Stepfather
     Other (please specify how related):

13. Parent/Guardian #1's e-mail address

14. Parent/Guardian #1's mailing address

15. Parent/Guardian #1's home phone number

16. Parent/Guardian #1's work phone number

More Parent/Guardian Info

17. Parent/Guardian #2's first name

18. Parent/Guardian #2's last name

19. This person is your:
     Mother
     Father
     Stepmother
     Stepfather
     Other (please specify how related):

20. Parent/Guardian #2's e-mail address

21. Parent/Guardian #2's mailing address

22. Parent/Guardian #2's home phone number

23. Parent/Guardian #2's work phone number

Technology

24. At home, I have access to (check all that apply):
     iPad
     Android Tablet
     Laptop computer (Mac, PC)
     Chromebook
     Desktop computer
     Internet access on computer

25. I have:
     No cellphone
     a "non-smart" phone: basic services and/or texting only
     an iPhone
     an Android phone
     Other (please specify):

26. I have:
     No programming experience
     very little experience (Scratch, Python, or other)
     some experience in Python, Javascript, PHP, web apps, etc.
     a lot of experience
     Other (please specify):

More Stuff About You

27. I go to

28. List any extracurricular activities that you're involved in at school.

29. List the things you like to do on your own time.

30. List a few of your favorite musical artists.

31. If you wish, enter any additional information here that you want to share with me that might help us to work together better in class.