Your Name: ______________________________________________________

Nickname: _______________________________________________________

Code Name (for posting grades): _________________________________

Date of Birth: __________________________________________________

Name of Parents or Guardians: ___________________________________

Home Address: ___________________________________________________

Home Telephone Number: __________________________________________

PRINT Your e-mail address: ______________________________________

List hobbies and interests: _____________________________________

        _________________________________________________________


School Activities in which you participate: _____________________

        _________________________________________________________

	_________________________________________________________

	_________________________________________________________

List Honors that you have received: _____________________________
     
	_________________________________________________________

	_________________________________________________________

List Community or Church Activities: ____________________________
     
	_________________________________________________________

	_________________________________________________________

List Colleges to which you are planning to apply: _______________

        _________________________________________________________

	_________________________________________________________
 
	

Your Schedule:                 
               Advisor:     _____________________________________

FIRST SEMESTER
			1st block:  _____________________________________

			2nd block:  _____________________________________

			3rd block:  _____________________________________

			4th block:  _____________________________________

SECOND SEMESTER
			1st block:  _____________________________________

			2nd block:  _____________________________________

			3rd block:  _____________________________________

			4th block:  _____________________________________

     		
List names of students (in this class) with whom you would like to work:
		_______________ , _______________ , _______________ ,  

		_______________ , _______________ , _______________  


List names of students (in this class) with whom you would prefer not to work:
		_______________ , _______________ , _______________  



Please write down something which you would like me to know about you (or something that makes you unique!):

        _________________________________________________________

        _________________________________________________________
 
        _________________________________________________________



What is your dream?

        _________________________________________________________

	_________________________________________________________

	_________________________________________________________