1. Default Section

* 1. First Name

* 2. Last Name

* 3. ID Number

* 4. Address

* 5. Phone

* 6. Email Address

* 7. Are you currently a teacher or school administrator?

* 8. In what degree program are you currently enrolled?

* 9. How do you connect to the Internet at home?

* 10. What previous Educational Technology classes have you taken?

* 11. Rate your experience with the following on a scale of 0 to 5. O is no experience and 5 is extensive experience.

  0 1 2 3 4 5
World Wide Web surfing
World Wide Web authoring with HTML
World Wide Web authoring with a Web authoring tool (e.g. FrontPage)
Web authoring with Cascading Style Sheets (CSS)
Web authoring with java script
Web authoring with Online Tools (e.g., Weebly, Wix, Google Sites)
Using email with students
Using the Web with students
Telecollaborative projects in your classroom
Teaching students to evaluate information on the Web
Web 2.0 tools in the classroom

* 12. Please comment on what you hope to achieve in this class.

* 13. I give Dr. Marcovitz permission to retain a copy of any of my work done in this class for his own professional development and for presentation to others (such as in future classes or at conferences). Checking "yes" will serve as an electronic signature.