Appendix B: Participant Information

Participant Information
DO-IT Scholars
University of Washington

Name of Participant:__________________________ Disability:______________________

Please describe how your disability affects your ability to do your schoolwork (in class and outside of class).

Do you use any of the following tools?
__ taped texts
__ interpreter
__ FM hearing system
__ note taker/scribe
__ wheelchair
__ Braille
__ large-print materials
__ personal attendant
__ guide dog
__ walking device
__ other (please describe):_____________________________________________________________________________________________

Which math course will you have completed by June 2005?
__ algebra
__ geometry
__ trigonometry
__ precalculus
__ calculus

Which science classes will you have completed by June 2005?
__ biology
__ chemistry
__ physics
__ geology
__ health
__ psychology
__ anatomy
__ earth science
__ other (please describe): ____________________________________________________________________________

Which computer classes will you have completed by June 2005?
__ HTML/web design
__ keyboarding
__ programming
__ computer aided drafting
__ other (please describe):___________________________________________________________________________________________________

Which computer software have you used?
__ Microsoft Word
__ WordPerfect
__ Microsoft Excel
__ Adobe PageMaker
__ Microsoft Windows
__ other (please describe):____________________________________________________________________________________________________________

Do you have experience using the Internet?
__ Web browser
__ FTP
__ email
__ HTML
__ other (please describe):_____________________________________________________________________________________________________________________________________________________________________________________________________________