ED 430: Creativity in the Elementary Classroom
Fall 2003

Name ______________________________
Phone #’s: _____________________________________________________________
Email Addresses: ________________________________________________________
Home / School Addresses: _________________________________________________
________________________________________________________________________
Parents / permanent / future Address & Phone #:______________________________

Course of Study (Majors/Minors): __________________________________________

At what grade level do you want to teach? Where do you hope to teach (state, city, school)? What subject areas are you most excited about teaching? Which ones are you least excited about teaching?

Do you consider yourself an artist / creative person? Why / Why not? How?

What courses (please include course titles) have you taken in the creative arts and education?

Number these with 1 being the LEAST comfortable and 5 being the MOST comfortable for you as a medium of expression:
Drama 1 2 3 4 5
Art 1 2 3 4 5
Music 1 2 3 4 5
Dance 1 2 3 4 5
Creative writing 1 2 3 4 5

On a scale from 1-10 how certain are you that you want to be a teacher? (Please Circle)
1 2 3 4 5 6 7 8 9 10
Have you had an opportunity to teach before? If so what subjects, grades, how often, in what capacity …?

How much information about these topics have you encountered in your coursework? Extensive Some A Little None

Multiple learning styles: __________________________________________________
Theories of Creativity: : __________________________________________________
Multicultural education: : _________________________________________________
Arts-based curriculum : __________________________________________________
Theories of Cognitive Development? : _______________________________________
Lesson Planning: : _______________________________________________________
Interdisciplinary Unit planning: ___________________________________________

Which, if any, of these topics have you had experience with as a teacher in schools?

What do you hope to gain from this course? What areas do you hope to cover?

What are your interests?

Is there anything that might affect your contribution/involvement in this course?

Comments?

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