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* 1. Type your name or student ID number below

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* 2. I am interested in online learning.

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* 3. I think that online school will help improve my grades and learning.

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* 4. Before coming to TVLA, I had good experiences with my teachers and school.

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* 5. I am enrolling in TVLA because I have anxiety or get nervous around people.

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* 6. I am enrolling in TVLA because I have no other options to earn my diploma.

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* 7. I have a difficult time following a schedule or waking up for classes or work and/or
I have a hard time sitting still and focusing for more than 30 minutes at a time. (CHECK ALL THAT APPLY)

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* 8. I lose things easily, have trouble turning in my assignments, and am usually late to school or appointments
(CHECK ALL THAT APPLY)

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* 9. After I graduate, I plan on attending college or going to a trade school to learn a skill (ex: welding,
cosmetology, mechanics, heating/cooling, construction, computers, nurses aide).

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* 10. I learn best by reading text, listening to information on headphones, and at looking and charts, graphs, & pictures on a computer screen.

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