Student Information Form

Student Information

Please fill out all of the following data and click the "Submit" button when you are finished.

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Data About You

Fill in your First and Last names the way you actually use them.

Which class are you in?:     A block Honors Physics 1 B block Honors Physics 2 D block CP1 (Regular) Physics 1 E block Honors Physics 1 G block Honors Physics 1 other or N/A * [Required]

Advisory room:      Class of: 2025 2026 2027 2028 * [Required]      Student ID #:

Guidance counselor Ms. Hart Ms. Merz Mr. Wilkins Ms. Molea Mr. Benecke Ms. Flamer Ms. Baletsa I don't know * [Required]

Personal Information

Gender: male female non-binary other:  Other (if not listed):

Pronouns: * [Required] he / him / his she / her / her they / them / their other: * [Required] Other (if not listed):

Is there anything I should know about using these pronouns in class, with your caretaker (parent/guardian/etc.), or anyplace else?

Date of birth: January February March April May June July August September October November December , 2003 2004 2005 2006 2007 2008

Primary language: * [Required] English Spanish Albanian Arabic Bengali Burmese Chinese Farsi French Greek Haitian Creole Hindi Khmer Lao Luganda Portuguese Pushto Russian Samoan Serbian Swahili Twi Ukranian Vietnamese Yoruba Zulu Other * [Required]

If you selected a language other than English above, do you speak English reasonably proficiently? yes    no

Your Contact Information

School Email: * [Required]

Personal Email:
Please double-check that you have typed your email address(es) correctly!

Preferred email address: * [Required] School Personal * [Required]

Phone number: (optional)
Please enter phone numbers with no spaces, dashes or anything else, as shown. Otherwise the form will give you an error.

Address:

Caretaker (Parent/Guardian/etc.) Contact Information

Photo Permission

I often take pictures of students taking part in experiments or activities. If I take a picture of a lab or activity that you appear in, may I include the picture (without your name) in things that might be seen by other people, such as a blog post?

yes      show me the picture and ask      no, never

Regardless of the above, if I think you might object to a particular picture, regardless of whether or not I might consider showing it to anyone else, I will either delete it or show it to you first and ask you about it.

Cold-Calling

How do you feel about being cold-called on in class? (This is when the teacher chooses you to answer a question instead of asking for a volunteer.)

Previous Math/Science Classes

Please list your most recent math and science classes and how well you did in them (to the best of your recollection). This will give me an idea of where your strengths are and where you might need help.

Accomplishments

Please tell me something that you're particularly proud of.

Concerns

Please tell me what you're most worried/concerned about when you take physics.

Accommodations

Are there accommodations (such as extra time, help with organizing, etc.) that you feel you need in order to be successful? Please list whatever you think you might need, regardless of whether or not you have an IEP or section 504 plan.

Family Members who Took Mr. Bigler's Physics or Chemistry Classes

If any of your relatives (brother, sister, cousin, etc.) graduated in 2012 or later and took one of my classes, please tell me their name and either when they took my class or when they graduated. (If you don't know, your best guess is fine.)

Your Superpower(s)

What superpower(s) do you have or wish you had?

What else should Mr. Bigler know?

What other things would it be good for me to know in order to help you be successful?

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Would you like to receive a copy of the email message generated by this form? yes      no
Note: This will be sent to your school email and it will work only if your email address is correct at the top of this from.