Semester in College (circle what applies) Fresh Soph Junior Senior // 1st semester 2nd sem.

Total number of credits so far ____________ GPA _______________

How many credits are you taking this semester?___________________

Expected semester of graduation (if all goes well) _____________________

Major (declared or inclined toward) ___________________________

Minor (as above) __________________________________________________

Have you considered the possibility of a double major? ________________

In which disciplines? __________________________

I am taking this course (choose as many as apply)

• ____ For fun

• ____ For the challenge

• ____ To fulfill a requirement (not for the major)

• ____ It's part of my major

• ____ It makes sense for my major although it's not required

• ____ I will need the skills/knowledge for my professional future

• ____ I had a good experience in High School

• ____ I heard good things about it or about the teacher

• ____ It’s going to be easy

• ____ I have to take some elective credits and it fits my schedule

• OTHER ____________________________________________________

You are looking to this course with a sense of (circle one)

Enthusiasm Anticipation Anxiety Fear and Loathing

• Your motivation in this course is: High Average Low

• Your motivation in college courses in general is: High Average Low

• How many hours a week do you expect you will have to work for this class? ____

• What grade are you aiming for? ____

• Do you work? Full time ____ Part time ____ How many hours per week (average)? ____

• What is your native language? __________________________

• Are you bilingual/multilingual? In what languages? ____________________________

• Are you fluent in other languages? ________________________________

• What languages are commonly spoken in your house? __________________

• What are the dominant languages in your neighborhood? ______________________

Do you own a computer _________desktop _____________laptop

Do you have access to broadband at home (DSL or Cable) Y N

How many hours a week do you spend online (fun and/or work) __________

Do you have a page on Facebook or similar social networks ____________

How often do you check your email ___________

Have you ever posted on blogs or Youtube __________