Why I’m Here Form Media Purpose Student Name: ____________________________ Date: _______________ Responsible teacher: _______________________ Arrival time: _________ Estimated time needed in media center: _______ Departure time: ______ Nature of Assignment: __________________________________________________________ _____________________________________________________________________________ Request help from Media Specialist? YES or NO If yes, nature of help needed: __________________________________________________ Should this student be using the computer? YES or NO Should this student be interacting with other students? YES or NO Should this student be working with or without certain materials? YES or NO If so, explain: _________________________________________________________________ Special Comments: _____________________________________________________________