Visitor Survey
Please fill out my survey. I am a teacher of middle school and high school students. The information which you supply will not be published. It will be used (1) to locate web pages of interest to my students and myself; and (2) to identify people who have interests and expertise which may be useful to my students or my professional development.
Instructions
1. Tab from one box to the next or move the cursor with the mouse. Do not press return! 2. Type information into blank boxes. 3. Click on boxes with typed entries, scroll down, and choose an answer.

1. Your Name: (Do not press return)

2. Your e-mail address: (Do not press return)

3. Your home page URL:

4. Your occupation:

5. Where do you live and work?

  • City?
  • State or Province?
  • Country?

6. What is your age range?

7. What are your major interests and areas of expertise?

8. Would you be willing to correspond via e-mail with students about your interests, expertise or occupation?

9. If you answered "yes" or "maybe,"for item 7, how often would you be willing to correspond with students about your interests, expertise or occupation?

10. Please provide your comments or questions about my page and this survey.

NOTE: Please click on "Send" to send the information to the author of this page. .