2020-2021 Distance Learning Application

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Please complete the following application to register for a distance learning foreign language class during the up-coming school year. The guidance department at your school will notify you of your enrollment status.

STUDENT LAST NAME: *

STUDENT FIRST NAME: *

DATE OF BIRTH: *

Power School Number *

Student E-mail Address *

Next school year (2020-2021) I plan to attend: *

Coats-Erwin Middle School

Dunn Middle School

Harnett Central Middle School

Highland Middle School

Overhills MIddle Scool

Western Harnett Middle School

Grade Level for 2020-2021 *

Grade 7

Grade 8

Parent/Guardian Name: *

Parent's Daytime Telephone Number *

Parent Email Address

Course Selection: *

SELECT ONE from the list of course offered at middle school.

Student Questionnaire

This following questionnaire should be completed by the student.

Who is most responsible for what and how much you learn? *

I am ultimately responsible for what and how much I learn.

The instructor and I share equal responsibility for what and how much I learn.

The instructor is most responsible for what and how much I learn.

Which statement best describes your personal motivation and self-discipline? *

I take pride in my ability to motivate myself.

I sometimes need others to encourage and motivate me.

I often need supervision to complete my assignments.

Which best describes your problem-solving skills? *

I enjoy solving problems on my own.

I enjoy solving problmes but sometimes need assistance.

I find problem solving difficult and often need assistance.

Which describes the ways you communicate with family, friends, and others? *

I routinely use e-mail, discussion boards, in addition to talking to them on the phone or in person.

I sometimes check my e-mail, but prefer to talk with them on the phone or in person.

I do not communicate with people unless I can meet with or talk to them.

Which statement best describes your ability to plan, prioritize tasks and organize assignments? *

I always plan ahead and stay organized.

I try to plan ahead but have some difficulty staying on task.

I always seem to be running behind.

I submit my assignments on time. *

Always. I plan ahead and stay organized.

I try to plan ahead but have trouble staying on task.

I always seem to be running behind.

Which statement best describes your interest in taking an online course? *

I'm very interested in taking an online course.

I'm somewhat interested in taking an online course.

I could be satisfied waiting to take an online course.

Which statement best describes your reading ability? *

I typically understand without assistance.

I sometimes need help understanding text.

I usually need assistance understanding text.

Which statement best describes your computer skills? *

I am comfortable with electronic mail, web browsing, word processing, and web 2.0 sites.

I can get by if there is not too much typing or special software.

I really don't like to use the computer.

Which of the following methods of instructor feedback do you prefer? *

Written explanation.

Both verbal and written explanation.

Oral explanation.

When you have a question, how quickly do you feel you need a response from your instructor? *

Within a few days.

Within a day.

Immediately.

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