First name

Last name

Your Email address (if you do not have one go to the next question)

Where were you born?

How long have you been in the United States? 1 year 2 years 3 years 4 years 5+ years

What languages do you speak at home?

How old are you? 14 15 16 17 18 19 20 +

What year are you? Freshman Sophmore Junior Senior

Do you write in a journal? yes no

What is your most favorite thing about school?

What is your least favorite thing about school?

What should Ms. Ali know about you? (likes, diskikes, hobbies, sports)