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    Echnology Uestionnaire

    Uploaded by

    James Lopez
    This document is a technology questionnaire for a student applying to the PlugGED In program. It asks whether the student has access to a computer and internet at home, how often they use a computer, and their familiarity with various technology tasks like word processing, emailing, web browsing, and computer programming. It also includes a personal statement prompt asking why they are interested in the program, what they expect to gain, and their education and employment goals after completing it. The final page is a referral form for someone to recommend the student and rate their dependability, motivation, academic potential and other attributes.

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    © All Rights Reserved
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    Echnology Uestionnaire

    Uploaded by

    James Lopez
    34 views5 pages
    This document is a technology questionnaire for a student applying to the PlugGED In program. It asks whether the student has access to a computer and internet at home, how often they use a computer, and their familiarity with various technology tasks like word processing, emailing, web browsing, and computer programming. It also includes a personal statement prompt asking why they are interested in the program, what they expect to gain, and their education and employment goals after completing it. The final page is a referral form for someone to recommend the student and rate their dependability, motivation, academic potential and other attributes.

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    This document is a technology questionnaire for a student applying to the PlugGED In program. It asks whether the student has access to a computer and internet at home, how often they use a computer, and their familiarity with various technology tasks like word processing, emailing, web browsing, and computer programming. It also includes a personal statement prompt asking why they are interested in the program, what they expect to gain, and their education and employment goals after completing it. The final page is a referral form for someone to recommend the student and rate their dependability, motivation, academic potential and other attributes.

    Copyright:

    © All Rights Reserved
    Download as DOC, PDF, TXT or read online from Scribd
    Download as doc, pdf, or txt
    34 views5 pages

    Echnology Uestionnaire

    Uploaded by

    James Lopez
    This document is a technology questionnaire for a student applying to the PlugGED In program. It asks whether the student has access to a computer and internet at home, how often they use a computer, and their familiarity with various technology tasks like word processing, emailing, web browsing, and computer programming. It also includes a personal statement prompt asking why they are interested in the program, what they expect to gain, and their education and employment goals after completing it. The final page is a referral form for someone to recommend the student and rate their dependability, motivation, academic potential and other attributes.

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    You are on page 1of 5

    TECHNOLOGY QUESTIONNAIRE

    STUDENT NAME DATE

    1. Do you have access to a computer at home? Yes No *

    * If No, where do you plan to access a computer? (check all that apply)
    Library
    Work
    A friend/relative’s house
    School
    Other ____________

    2. Do you have Internet access at home? Yes No *


    3. If so, what type of connection do you have?
    Dial-up
    Cable/DSL/ other high-speed connection (i.e. FIOs)
    Don’t know

    4. How often do you use a computer to access the Internet? (Choose one)
    A few times a day Once a week
    Once a day A few times a month
    Several times a week Never

    For each item, check the box that best describes your familiarity with the following technology tasks.
    NONE AT A LITTLE FAIRLY EXTREMELY
    ALL
    General computer use (basic functions,
    mouse, etc.)
    File management
    Sending email
    Sending email attachments
    Instant messaging (IM)
    Texting (SMS)
    General web use (browsing)
    Web searching
    Word processing (i.e. Microsoft Word)
    Creating spreadsheets (i.e. Microsoft
    Excel)
    Creating presentations (i.e. Microsoft
    PowerPoint)
    Taking pictures with a digital camera
    Downloading pictures from a digital
    camera to a computer
    Creating web sites

    Application Addendum I
    TECHNOLOGY QUESTIONNAIRE
    Blogging
    Computer programming (C+, HTML, SQL,
    etc.)

    Application Addendum I
    PERSONAL STATEMENT

    STUDENT NAME DATE

    Please use the space below to tell us why you are interested in participating in the PlugGED
    In program. In your statement, please address the following questions:
     why you are interested in enrolling in a GED-technology employment class like PlugGED
    In
     what you expect to gain from participating in the program
     what are your education and employment goals once you complete the program (i.e. get
    a job, go to college, etc.)

    Application Addendum III


    REFERRAL FORM

    Return to: Linda Allen


    Southwest Regional Adult Education
    1 School Board Drive
    P.O. Box 8
    Lebanon, VA 24266
    APPLICANT INFORMATION (TO BE COMPLETED BY PLUGGED IN APPLICANT)

    Last Name First Name MI


    Address
    City State Zip
    Email address __ Phone ( ) _____________

    This applicant above is applying to enroll in PlugGED In, an innovative six-month long course
    that prepares participants to earn their GED credential and Career Readiness Certificate
    (CRC) as well as valuable technology certifications and workplace readiness skills. This
    curriculum will prepare the applicant for an entry-level position in a technology sector
    industry or for admission into additional post-secondary education and training.

    REFERRER’S INFORMATION
    Name
    Title
    Address
    City State Zip
    Email address Phone (__ )

    1. How long have you known the above applicant? _____________

    2. Briefly describe how you know the applicant: _________________ ________________________

    3. Please use the scale below to rate the applicant in the following areas
    EXCELLEN GOOD AVERAGE POOR DON’T
    T KNOW
    Dependability
    Independence
    Motivation
    Perseverance
    Academic potential
    Teamwork skills
    Leadership ability
    Work/study habits

    Application Addendum IV
    REFERRAL FORM
    Creativity

    4. Overall, do you recommend that the applicant be accepted into the PlugGED In program?
    Highly recommend Recommend Do not recommend
    Do not know

    Application Addendum IV

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