Success in the classroom often depends on sharing information,
difficulties, and concerns with the teacher. Below, please find a
questionnaire that is for my use only. By completing this
form, you will also make me aware of the difficulties that you
might face in taking this course, any obstacles you might have in
completing it, and any other concerns that you might have. I am
here to help you succeed in this course in any way I can.
1) Will you have any difficulties enrolling in the class at the start of the semester?
If so, please describe. The College requires that all students attending class
be enrolled, but I can give a one week extension during the first week of classes.
2) Will you need any additional help outside the classroom, such as
tutoring, consulting with me during office hours, study groups?
3) Will you have any difficulties obtaining the text or needed
materials for the class?
4) Will you have any difficulties in reading/understanding the text and
chapter quizzes? Do you have any speaking/language difficulties
that might make it hard for you to respond to questions in class?
5) Are you able to attend all the class meetings? If you can foresee
being absent from class, please let me know here and the reason
for the absence.
6) Do you have access to a computer at home or at work that you can
use? Does it have the recommended operating systems and browsers? Do you have access to the Internet? Do you have an email
7) Will you need help in taking notes? Do you have any writing
8) Do you need special accommodations in the classroom? Do you need a
seat near the front of the class for hearing and seeing purposes?
Do you need a special chair?
9) Is there anything in the classroom environment that may not be
conducive to your health, and learning (ie fragrances, allergies to
chalk, excessive noise, lighting, temperature)
10) Is there anything that you would like to tell me about yourself
that you think that I should know?
11) Will you have any difficulties in solving basic math problems?
12) What are the specific things that you need to learn in this course?
15) What is your email address or phone number so that I can contact you if need be in addressing the concerns you have mentioned above?