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2019 Student Information
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* Indicates required question
During what period do you have Mr. Kopkas in class this year?
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1
2
3
4ab
4bc
4c5a
5ab
6
7
Last Name
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Your answer
First Name
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Your answer
Home Address
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Your answer
Primary Email Address
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Your answer
With whom do you live?
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Both Parents
Mom only
Dad only
OTHER
If your answer above was "Other", describe who below?
Your answer
Mom's Last Name
Your answer
Mom's First Name
Your answer
Mom's Home Phone Number
Your answer
Mom's Work Phone Number
Your answer
Mom's Cell Phone Number
Your answer
Mom's Primary Email Address
Your answer
Dad's Last Name
Your answer
Dad's First Name
Your answer
Dad's Home Phone Number
Your answer
Dad's Work Phone Number
Your answer
Dad's Cell Phone Number
Your answer
Dad's Primary Email Address
Your answer
Last Year's Math Teacher (mark ALL that apply)
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Ms. Burgess
Mr. Carnes
Ms. Csarny
Mr. Dingman
Ms. Guseilo
Mr. Havens
Ms. Holman
Mr. J. Kleinhenz
Ms. M. Kleinhenz
Mr. Kopkas
Ms. Kyler
Mr. McKeen
Ms. Miller
Ms. Moeschberger
Ms. Somerville
Ms. Speelman
Mr. Wentz
OTHER (came from Solon Middle School, came from another district, etc.)
Required
List the extracurricular activities (sports, clubs, MIM, etc.) with which you plan to be involved this school year. If none, write "NONE".
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Your answer
Is there anything that I should know about you that may affect your performance in class this year?
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Your answer
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