Power Mechanics

CTE Student Survey

THIS INFORMATION IS CONFIDENTIAL

Career Program (required) Power Mechanics

Teacher's Name (required) Mr. Billeter

Student First Name:

Student Last Name:

Student Cell Phone (###-###-####):

Grade Level: (required) 9th 10th 11th 12th

Student Email:

Guardian #1 Name:

Guardian #1 Phone (###-###-####):

Guardian #1 Cell (###-###-####):

Guardian #1 Email:

Guardian #2 Name:

Guardian #2 Phone (###-###-####):

Guardian #2 Cell (###-###-####):

Guardian #2 Email:

Nearest Relative Name:

Nearest Family Member Phone (###-###-####):

Nearest Family Member Cell (###-###-####):

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