http://www.shuilongs.com/studneed.html

Internet Classes SHUILONG

Student Needs Assessment

Complete the Questions below and submit/mail/fax/deliver to the instructor:

Student's Name

Student's Mailing Address

City

State

Zip Code

Home Phone

Day Phone

Fax Number

(student's EMAIL address - if have one)

(any other student email address)

What type of computer will you be working on for this course?
Win 3.x Win 95/NT Apple/Mac
How will you be accessing the Internet?
Home Computer Work Computer School/College Other
Are you already connected to an ISP (Internet Service Provider)?

Yes
No
If yes, who is your ISP?
If no, do you wish information on how to connect your computer to the UACN-ACAD1 ISP?

Yes
No
What Internet software programs are on the computer's hard disk drive? (if you know)
Do you have manuals available on operating the computer and it's software?

Yes
No
Which type of communication software will you be learning/using? (if you know)
What type of modem are you using and what is it's speed? (if you know)
Do you already know how to use a modem and telecommunications software?

Yes
No
Have you ever used electronic email before?

Yes
No
Do you already have an email account?

Yes
No
If yes, what is your email address?
If no, do you wish a temporary Internet email address?

Yes
No
What type/size disk drive will you be using for this course?

MAC
IBM 3.x Disk
IBM 5.x Disk
Why did you sign up for this class?
What would you like to accomplish in this course? (how can this course help meet your personal or professional needs?)
Self-directed learning does not mean learning in isolation. We encourage you to learn with a buddy, even if that person is not taking the course. This buddy can be at the same level of skill or can be a more experienced computer user. Do you have a buddy?

Yes
No
If yes, Who? (if not, the instructor will introduce you to an online buddy)
Describe your previous experience using a personal computer.
Assess your current skill level using your computer. 1 = you are a "newbie" brand new to computers, 10 = you are very experienced and very comfortable with your computer.

One
Two
Three
Four
Five
Six
Seven
Eight
Nine
Ten
(optional) Send a small picture so that the instructor and computer lab staff can put your name with your face. Is it alright if the Instructor puts your photo on your student status page for other students to view?

Yes
No
(optional) Write a biographical sketch of yourself: what you do, where you live, your family situation, anything that would help the instructor and other students understand your background and specific learning needs. Is it alright if the Instructor puts your photo on your student status page for other students to view?

Yes
No

Please click here when form is complete:

How To Submit The Form

Online Web Form: *fastest
Fill out the online form and click the submit button to send directly to the instructor.
Snail Mail:
Rita Fuller
3208 HPR 10
Sitka, Alaska 99835
UAS-S Virtual Classroom Menu
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CIOS: 145: Internet Concepts and Applications
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CIOS: S293: Advanced Internet | F246: Advanced Internet
CIOS: 153: Web Publishing Concepts/Applications | 255: Web Publishing Concepts/Applications/HTML II
Continuing Education Workshops: CE-Power Navigating the Web | CE-Web Page Making

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