1. I am primarily a:
   Mathematics teacher
   Science teacher
   Technology teacher
   Other

2. I basically teach in the:
   Elementary school
   Middle school
   Secondary school
   Other

3. I am knowledgeable about computers.
   Yes
   No

4. I feel that computers and telecommunication technology exerts an impact upon my role as an educator.
   Yes
   No

5. I feel that computers and telecommunication technology exerts an impact upon my school.
   Yes
   No

6. I use computers:
   Daily
   Weekly
   Monthly
   Never

7. I would like to be in-serviced on using state-of-the-art computers in general.
   Yes
   No

8. I would like to be in-serviced on the integration of computers into the school setting.
   Yes
   No

9. I would like to be in-serviced on telecommunication technology in general.
   Yes
   No

10. I would like to be in-serviced on the integration of telecommunication technology in the school.
    Yes
    No

11. I use computers for: (Check all that apply)
    Word processing.
    Developing electronic files and folders.
    Creating databases and spreadsheets.
    Information gathering and analyses.
    Desktop publishing and creating or accessing graphics.
    Mathematical applications.
    Related functions such as accessing student records, schedules, etc.
    Maintaining files.
    Curricular and instructional purposes.
    Data gathering (i.e. remote temperature sesing with a probe interface).
    Educational research.
    Evaluation and assessment purposes.
    Creating and/or planning educationally innovative activities.
    Other

12. I am knowledgeable about telecommunication technology.
    Yes
    No

13. I use telecommunication technology:
    Daily
    Weekly
    Monthly
    Never

14. I use telecommunication technology to: (Check all that apply)
    Communicate within the school setting via E-Mail to others
    Communicate externally via E-Mail to colleagues and professionals
    Disseminate information to parents and the community-at-large
    Gain access to valuable information resources on the Internet
    Conduct research
    Participate in discussion educationally related newsgroups
    Gain access to information and news
    Other

15. My school building or district currently retains at least one computer laboratory containing state-of-the-art computers.
    Yes
    No
    I Don't Know

16. My school classrooms currently contain state-of-the-art computers (ex. Intel Pentium 166's with 2.0 gigabyte or better harddrives and 16 megabytes or better of RAM).
    Yes
    No
    I Don't Know

17. My school building/district contains a state-of-the-art LAN or local access network.
    Yes
    No
    I Don't Know

18. My school building is connected to a state-of-the-art WAN or wide area network.
    Yes
    No
    I Don't Know

19. My school building is connected to the Information Superhighway through an Internet access service provider.
    Yes
    No
    I Don't Know

20. The Internet Access provider for my school is:
    Local (Third-Wave Development)
    National (ex. America On Line or CompuServe)
    None
    I Don't Know

21. Teachers, other professional staff and itinerant staff in my building or district currently use computers and telecommunication technology on a regular basis.
    Yes
    No
    I Don't Know

22. Teachers in my building or district currently integrate computers and telecommunication technology as an essential part of classroom curriculum and instruction on a regular basis.
    Yes
    No
    I Don't Know

23. Teachers in my building or district are proficient at using computers and telecommunication technology.
    Yes
    No
    I Don't Know

Prioritize in rank-order fashion your school's perceived wants and/or computer and associated technology needs as a teacher of matcience, or technology. The number one (1) indicates the highest order priority while the number five (5) indicates the lowest priority order on the list.

1.

2.

3.

4.

5.

Prioritize in rank-order fashion your schools perceived wants and/or telecommunication technology needs as a teacher of matcience, or technology. The number one (1) indicates the highest order priority while the number five (5) indicates the lowest priority order on the list.

1.

2.

3.

4.

5.