ROOM 115

Name:		Address:
City:		Zip:

What period do you take Keyboarding?

First Period Second Period Third Period Fourth Period Fifth Period Sixth Period

Email Address:		Home Phone:
Dad's Name		Dad's Work Phone:
Mom's name
Mom's Work Phone:

Do you have a computer at home?

Yes No

What math class are you taking this year?

Geometry Algebra II Pre-Calculus Calculus

What is your experience with computers?