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Student Interest Survey
Christopher Brechlin
2022-05-12T12:16:00-04:00
Name
(Required)
First
Middle
Last
Suffix (like Jr or III)
Preferred Name - Nickname
Birthday
(Required)
Month
Day
Year
Age
(Required)
Who is Your Peacebuilder?
(Required)
Choose One
Alberto Rivera
Anthony Pearl
Brian Evans
Carlos Rodriguez
Derrick Brathwaite
Diego Lopez
Erika Roberts
Ji Whitaker
John Gwynn
Johnny Rodriguez
Mildred Guzman
Warren Hardy
Are you attending school regularly?
(Required)
Yes
No
Graduated
Why aren't you attending school? (Check all that apply)
Boring/Stupid
Medical issues
Need to work
No transportation
Too hard
Unsafe
OTHER
If other, explain more:
What school are you enrolled in?
(Required)
Select Your School
A.I. Prince Technical School
Academy of Science and Innovation
Achievement First High School
Adult ED
Atabrook
Bloomfield High School
Bulkeley High School - Lower
Bulkeley High School - Upper
Capitol Prep High School
Civic Leadership High School
Classical Magnet High School