Last Name:       First Initial:  
                                                         Example:  Your first name is Jose - you'd enter J

ID#:  

Grades:  What were  your grades for the first semester ending December 2007.

Language Arts:   Select One 90-100 75-89 70-74 50-69

Math:   Select One 90-100 75-89 70-74 50-69

Free and Reduced Lunch:   Select One Yes No
Do you pay less than $2.50 for a school lunch?

Attendance:   Select One 0-5 absenses 6-9 absenses 10+ absenses
How many days did you miss school per semester?

Family Information:   Select One 1 Parent Home 2 Parent Home
How many parents that are married live with you?

Sibling Information:  Select One 0-1 sibling 2 siblings 3+ siblings
How many brothers and sisters are living with you?

College Attendance:   Select One 1 parent graduated from college 2 parents graduated from college I will be the first in the family to attend college
How many of your parents have graduated from college?

Discipline:  Select One Zero Office Referrals Minor Infractions (Detentions, etc.) Serious Infractions (Suspended, etc.)
Ask your teacher for clarification if you are confused with this question.