Chem 1 Information Form
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First Name *
Last Name *
Nickname
Enter any nickname you'd like to be called
Textbook # *
Book numbers are usually in the form XX-##, where X is either a letter or a number and # is a number. Enter "None" if you opted not to take a textbook.
Westfield Google account (ends in @westfieldnjk12.org) *
Other e-mail address, for communication *
YOUR Cell phone # *
Use the format (###)###-####
Birthday (MM/DD only)
If you want us to celebrate your birthday (class acknowledgment and tootsie pops!) enter it here. Summer birthdays will be celebrated at your half-birthday..
MM
/
DD
Starting with 9th grade, list your previous and concurrent science classes, including year taken (9, 10, 11, 12), teacher, and course title (one per line). You do not need to include this course. *
e.g. 9th, Boyle, Biology
What extracurricular activities (sports, music, etc.) do you participate in?
Sometimes it takes me a while to make a connection to an older sibling that I taught. Please list any older sibling(s) that have had me (one per line).
I have read and understand the class requirements I received in class. *
Required
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