Motivation High School
Home of the Panthers
Motivation High School
78th Street and Buist Avenue
Philadelphia PA 19153
(215 492-6987
Student Data Sheet
First Name
Last Name
Address
City
State
ZIP
Home Phone #
Emergency Contact Phone #
Emergency Contact Name
Book #
Computer Applications You're Familiar With (check all that apply)
Microsoft Word
Front Page
Excel Spreadsheets
HTML
Access
Power Point
Other(explain in Comments below)
Do you have a computer at home?
(Check One)
Yes
No
Your interests in computers include (check all that apply)
Games
Videos, Music
Education & Classwork
Don't Have an Interest
Comments?
What would you like to learn in this course?