Your School's or Program's Name
City
State (Province) Zip Code
Country

What population do you primarily serve?

Urban
Suburban
Rural
Other

The population is primarily:

Low-Income   Middle Class   Upper class

How would you classify your school?

Public
Public Charter
Parochial
Independent
Home
Other (please specify):

If in the US, can you estimate the ethnic breakdown as a percentage?

What grades are the students in who you intend to use The Odyssey's Mexico Trek with (or what age are the youth in your program), and how many are there?

What classes are the students in with you?

all are Macintosh
all are PCs
some of both   more are Macs more are PCs

Which web browser are you using?

How many internet-ready computers do you have access to?

I have 1 on my desk.    Number of classroom computers
I use a computer room.    Number of computer room computers

What is the speed of your modem or internet connection?

2400   9600   14400   28800   33600   56K
ISDN   Fractional T1 or higher   Who Knows?

Do you have enough computers for all of your students?

Yes   No

If not, what is the ratio of students to computers?

2/1 or less   3/1   4/1   5/1   6/1 or more

Have you participated in any other Internet-based projects?

Yes   No

If yes, which?

How experienced are you with using the Internet?

Very - You use it several times a week for researching topics and email.
Somewhat - You use it for email and have "surfed" the web a couple of times.
Not Very - You have seen someone else use it and know what it's about.
What's the Internet?

What is your primary objective in using The Odyssey's Mexico Trek?

To learn ways to use The Internet as an educational tool
To educate my students on using the Internet
To educate my students about diverse cultures worldwide
To educate my students about urgent global issues
To develop in my students a strong sense of social responsibility
To educate my students about ways they can effect change in the world
To develop in my students a confidence in their ability to shape their own futures
Other

Your Name
Your Email

Thank You very much!