Your Contact Information

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This is an intake survey for Jeff Anderson's class.

Please fill this out by the 11:59pm on Tuesday of week 1.

If you need extra time, please let Jeff know and we can figure out the best way for you to submit this.

1A. Last name: *

1B. First name (your legal name you used to enroll at Foothill College):

1C. What name do you prefer? Please tell Jeff how you would like to be known (you can list multiple options if you'd like). *

2A. Preferred Phone Number (enter without symbols) *

2B. What are the features of your phone? *

Call

Text

Don't have a Phone.

Other:

Required

2C. Can our learning team contact you at the phone number you gave above and discuss details about your participation in this class? *

Yes

Other:

2D. Preferred Email Address

2E. Due to the COVID19 lockdowns, we will be learning in a virtual format using Zoom software in this class. One feature of this class that I hope we can build is the ability to work in small groups using the Breakout Room feature in Zoom. My desire to have you work in small groups stems from my belief that you are good at math and that you have the capacity to create any knowledge that you're interested in learning. With that said, in order to create break out rooms, I need to know which email address you use with zoom. Please share that email address below:

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