Student Survey
Please complete all questions to allow for greater communication this year.
* Required
Student Name:
*
Enter both first and last name here
Period:
*
Choose your period number from the list below
EFB Period 1
EFB Period 2
EFB Period 3
EFB Period 4
EFB Period 5
Student Email Address
If you don't have one, please create one in google mail
Mother's Name
Mother's Occupation
Father's Name
Father's Occupation
Home Phone Number
Student Cell Phone Number
Mother's Work Number
Father's work number
Parent email
List the general email address for your home
Additional email addresses
Primary Language spoken at home
Family members' hobbies/other interests
check all that apply
Accounting
Photography
Sports Medicine
3D Animation
Business Owner
Human Resources
Web Design
Computer Programming
Graphic Design
Law
Art
Video/Digital Media
Do you have access to a computer at home?
Yes
No
What occupation are you interested in pursuing?
What college/training/service do you plan on attending?
Tell me here where you see yourself next September
Additional Information
Enter any information you think I should know