pntout2.wmf (33846 bytes) ETEC 512/712
Human Performance
Technology

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Student Information Form

So that I can provide you with a learning experience that is of most value to you, I would like to learn a little bit more about you by Tuesday, September 9, the beginning of the second class session.

Instructions: Please copy these questions into an e-mail message, then send to me by e-mail at saulcarliner@gmail.com.

Note that you cannot fill this out as a form. Thanks for your cooperation.

Who Are You?

  1. Name: __________________________________________
  2. Previous Degrees (list degree and school): ___________________
  3. Current employment: _________________________________

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About Your Interest in the Course

  1. What do you hope to do with your degree in educational technology (such as work as a school technology specialist or take a job designing training courses in industry?

    2. _______________________________________________________

    _______________________________________________________

  2. If this course were not required, would you take it?

    3. __ Yes Why? ____________________________________________

    __ No Why? ____________________________________________

    Describe your previous experience with designing learning programs (whether for the corporate world, primary and secondary education, or colleges and universities?

    _______________________________________________________

    _______________________________________________________

  3. Describe your previous experience with writing and developing other types of informational materials, such as user’s guides, policies and procedures, multimedia programs, and the like.

    4. _______________________________________________________

    _______________________________________________________

  4. How would you rate your ability to design learning materials (choose one):
    1. I'm totally self-conscious; I don't feel good at it yet.
    2. I'm fair.
    3. I'm not able to assess myself
    4. I can hold my own, but I'm no Bill Horton (a current hot-shot in training and learning design)
    5. I'm gifted
  5. What is the one thing you hope to learn from this course?

    6. _______________________________________________________

    _______________________________________________________

  6. What excites you most about starting this course?

    7. _______________________________________________________

    _______________________________________________________

  7. What is your most significant concern entering this course?

    8. _______________________________________________________

    _______________________________________________________

  8. How do you think the knowledge learned in this course will benefit you in your career as an educational technologist?

    9. _______________________________________________________

    _______________________________________________________

  9. What else would you like for me to know?

    10. _______________________________________________________

    _______________________________________________________

Once again, please copy these questions into an e-mail message by Tuesday, September 9, then send by e-mail to Saul Carliner saulcarliner@gmail.com.

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