Skills Assessment Survey

Please take a moment and fill out the form below. I will use this information to help tailor the course based on your
individual needs and interests.
General Information
Do you own a computer? Yes No

If so, what operating system do you use?
Windows 2000, XP, Vista, 7 (PC)
Mac OS (Tiger, Leopard, Snow Leopard, etc.) (Apple)
Linux
Other

What kind of computer do you own?
Desktop
Laptop
Netbook
Tablet
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How old is your computer?
Brand new!
1 year old
1-2 years old
2-3 years old
3-4 years old
4 or more years old

How many hours per week do you spend using a computer?
0-5 hours
6-10 hours
11-15 hours
16-20 hours
21-25 hours
26-30 hours
30-35 hours
36-40 hours
40 or more hours

I am comfortable using online Help or a manual to solve problems and research answers to my own
questions.
Yes No

I am familiar with how a computer generally works.
Yes No

I understand about how most computer peripherals operate and am comfortable installing them.
Yes No
Technology Skills
Please rate your experience level on a scale of 1 to 5, where 1 represents no experience with this skill
and 5 represents expert-level mastery of this skill.

Identifying, downloading and installing browser plugins.

1 2 3 4 5

No experience with this skill

Expert at this skill

Multitasking - using more than one program at a time or viewing more than one web page at a time.

1 2 3 4 5

No experience with this skill

Expert at this skill

Using a word processing program such as Microsoft Word, Microsoft Works, or WordPerfect.

1 2 3 4 5

No experience with this skill

Expert at this skill

Using a graphical presentation program such as Microsoft PowerPoint or Key Note.

1 2 3 4 5

No experience with this skill

Expert at this skill

Using a spreadsheet program such as Microsoft Excel.

1 2 3 4 5

No experience with this skill

Expert at this skill

Using a graphical manipulation program such as Adobe Photoshop to alter digital photographs.

1 2 3 4 5

No experience with this skill

Expert at this skill

Working wtih your computer's operating system (creating folders, managing files, etc.)

1 2 3 4 5

No experience with this skill

Expert at this skill

Using HTML and CSS to build your own web pages

1 2 3 4 5

No experience with this skill

Expert at this skill

Working with animated graphics (building your own simple animated movies or GIFs)

1 2 3 4 5

No experience with this skill

Expert at this skill

Using a commercial web publishing package such as Adobe DreamWeaver to build a website

1 2 3 4 5

No experience with this skill

Expert at this skill

Using an interactive media development package such as Adobe Flash to create interactive websites or
games.

1 2 3 4 5

No experience with this skill

Expert at this skill
Technology Usage
Please answer the questions below in regard to your own personal use of technology.
Do you own an iPod or other personal music player?
Yes No


Does your mobile phone have access to the Internet?
Yes No
If so, do you use it regularly?
Yes No
Have you had any experience with a virtual world (i.e. Second Life, There, Activeworlds, Wonderland,
etc?
Yes No
Have you shared artistic content online such as photos, artwork, stories, videos, etc?
Yes No
Have you created your own online journal or blog?
Yes No
Have you created a profile on a social networking site?
Yes No
Have you ever uploaded photos to an online space where others can see them?
Yes No
Do you watch videos on video sharing sites such as YouTube?
Yes No
Have you ever posted a video online?
Yes No
Do you use e-mail to communicate with personal or professonal contacts on a daily basis?
Yes No
Personal Information
Your preferred e-mail address ______________________________________