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\begin{document}
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\begin{center}
\textbf{Technology Survey}\vspace{1cm}
\end{center}
\noindent Name: \hrulefill\\
\begin{enumerate}
\item Do you own a laptop computer?
\two{Yes}{No}
What operating system(s)?
\four{Windows}{MacOS}{Linux}{Other: \hrulefill \hrulefill}
\item Do you own a desktop computer?
\two{Yes}{No}
What operating system(s)?
\four{Windows}{MacOS}{Linux}{Other: \hrulefill \hrulefill}
\item Do you own a tablet?
\two{Yes}{No}
What type(s)?
\five{IPad}{Android}{Windows (RT)}{Kindle}{Other: \hrulefill \hrulefill}
\item Do you own a smartphone?
\two{Yes}{No}
What type(s)?
\four{IPhone}{Android}{Windows RT}{Other: \hrulefill \hrulefill}
\item Do you own an advanced (graphing, CAS, or programmable) calculator?\bigskip\\
Type(s): \hrulefill
\item What programming languages are you familiar with?\bigskip\\
Please list:  \hrulefill\bigskip
\end{enumerate}
Please rate your knowledge of the following software programs and technology:\medskip
\begin{enumerate}\addtocounter{enumi}{6}
\item MS Excel (or other spreadsheet software: \hrulefill)
\five{none}{minimal}{average}{good}{expert}
\item MS Powerpoint (or other presentation software: \hrulefill)
\five{none}{minimal}{average}{good}{expert}
\item Desmos:
\five{none}{minimal}{average}{good}{expert}
\item Other advanced (graphing, CAS, or programmable) calculators:
\five{none}{minimal}{average}{good}{expert}
\item RPN calculators (Hewlett-Packard):
\five{none}{minimal}{average}{good}{expert}
\item Data collection tools for calculators (Texas Instruments):
\five{none}{minimal}{average}{good}{expert}
\item Networked calculators (TI-Nspire):
\five{none}{minimal}{average}{good}{expert}
\item SmartBoard:
\five{none}{minimal}{average}{good}{expert}
\item \LaTeX\ (or \TeX):
\five{none}{minimal}{average}{good}{expert}
\item Beamer:
\five{none}{minimal}{average}{good}{expert}
\item Geogebra:
\five{none}{minimal}{average}{good}{expert}
\item Geometer's Sketchpad:
\five{none}{minimal}{average}{good}{expert}
\item Cabri Geometry:
\five{none}{minimal}{average}{good}{expert}
\item Cinderella:
\five{none}{minimal}{average}{good}{expert}
\item Mathematica:
\five{none}{minimal}{average}{good}{expert}
\item Maxima:
\five{none}{minimal}{average}{good}{expert}
\item Other CAS systems: \hrulefill
\five{none}{minimal}{average}{good}{expert}
\item MatLab:
\five{none}{minimal}{average}{good}{expert}
\item Stella (Modeling and Simulation):
\five{none}{minimal}{average}{good}{expert}
\item Minitab:
\five{none}{minimal}{average}{good}{expert}
\item R (Statistics):
\five{none}{minimal}{average}{good}{expert}
\item Logo - Programming for kids:
\five{none}{minimal}{average}{good}{expert}
\item Camtasia, Yuja (or other desktop video capture software: \hrulefill)
\five{none}{minimal}{average}{good}{expert}
\item Video camera equipment:
\five{none}{minimal}{average}{good}{expert}
\item Web-authoring tools: \hrulefill
\five{none}{minimal}{average}{good}{expert}
\item LEGO Mindstorms:
\five{none}{minimal}{average}{good}{expert}
\item Linux-type OS distribution such as Ubuntu or Debian:
\five{none}{minimal}{average}{good}{expert}
\item Apache SubVersion (or other versioning software:  \hrulefill):
\five{none}{minimal}{average}{good}{expert}
\item What other (loosely) Mathematics-related technology are you familiar with?
\end{enumerate}
\newpage
\noindent Are you currently teaching?
\two{Yes}{No}
At what grade level?
\five{Elementary}{Middle}{High}{College}{Other: \hrulefill \hrulefill}[1.5\baselineskip]
\noindent What technology have you used in Mathematics classrooms as a teacher? 
\vfill
\noindent What technology have you used in your Mathematics classrooms as a college student?  
\vfill
\newpage
\noindent What Mathematics technology have you learned on your own?
\vfill
\noindent What do you want to learn in this course?
\vfill\vfill\vfill
\noindent Additional comments:
\vfill
\end{document}