C.I.T.Y Virtual Program Readiness Questionnaire

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Online learning is NOT for everyone. It requires a great deal of self-discipline and self-monitoring, which are common characteristics of independent learners. Additionally, a cohesive partnership between parents, students and our staff is essential. Online classes also require a great deal of reading and interacting with staff through the use of webinars and emails. Please take time to consider your options carefully.

Email *

This brief questionnaire will help us determine your readiness for virtual learning. Answer each question honestly and to the best of your ability. *

YYYY

First and Last name of person filling out questionnaire:

First and Last name of student:

Technology Skills: *

Student has little experience using technological devices or the internet.

Student has limited experience using technoloy, but is developing an interest in this area.

Student has adequate skills using technology for their age, and is very interested in this area.

Student has excellent computer skills for their age, and is very comfortable working with applications like word processors and Google apps.

Motivation: *

Student has little to no interest in learning new content, and has a negative attitude regarding learning.

Student is interested in learning new content, but sometimes appears unmotivated.

Student has interest in learning new content, has a positive attitude about learning, and is motivated to succeed.

Student has a strong interest in learning new content and is highly motivated to learn.

Work Habits: *

Student often needs reminders to complete school-related tasks, is not a self-directed learner, and struggles to complete school work alone.

Student is beginning to demonstrate self-directed learning, but still requires continuous support and feedback.

Student is a self-directed learner and rarely needs reminders to complete school-related tasks.

Student is a self-directed learner and has demonstrated a high level of success working independently.

Time Management: *

Student does not manage time effectively in completing tasks.

Student is beginning to demonstrate effective time management when he or she is interested in the task.

Student effectively manages time and completes tasks in a timely manner in most subject areas.

Student has demonstrated a high level of effective time-management and multi-tasking with great success in all subject areas.

Support Services: *

There is little to no support for online learning in the home. There is no one in the home during the day to provide support and assisstance.

Support is limited, and is dependent on family schedules.

Student has support in the home daily. Learning Coach is always available.

Student has outstanding support in the home that can work collaboratively with Virtual Teacher to ensure student success.

Communication: *

Student struggles with reaching out to their teacher for support. Unwilling to seek help when needed.

Student is nervous about reaching out to their teacher for support.

Student is comfortable reaching out to their teacher for support.

Student proactively contacts the teacher with questions and/or clarification if needed. Student is willing to advocate for his/her self.

Learning Coach: Is there an adult who can supervise the student's learning each day, and offer help and support as needed? *

Yes

Will the student be comfortable using a computer five days a week (for 4-6 hours daily) to participate in class? *

Yes

Is the student able to come to the board office as needed for state and district testing? *

Yes

Do you have reliable, high speed internet? *

Yes

Do you understand that this is an ASYNCHRONOUS course, meaning that students will be learning material on their own, with the help of a parent or learning coach? (Mrs. Ballard will be available most days for office hours if needed)

Yes

Clear selection

Is your family willing to commit to the C.I.T.Y Virtual program for the entirety of the 2022-2023 school year?

Yes

Clear selection

Please type the address where the student will reside:

Does your child currently receive educational accomodations?

Yes

Clear selection

Is the student interesting in taking specials classes at Scott Elementary school, such as art, music, PE, etc?

Yes

Not at this time

Clear selection

A copy of your responses will be emailed to the address you provided.

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