This form will gather information so that Dr. Bowman will know you better and to ascertain the level of
access you have to a computer. It also makes sure you know how to get to
our course webpage.
Your Email Address:
Confirm Email Address:
The three questions below are asked in order to enable Dr. Bowman to
understand each student's situation more clearly.
Where do you live?
of Lezha District
With whom do you live?
and Other Brothers and/or Sisters
Family or Friends
With what religion do you most closely identify?
In which grade are you at Lezha Academic Center?
Where is the computer you are using to fill in this form?
Lezha Academic Center
My Phone or Tabllet
Other (explain at right)
If 'Other', briefly explain:
Do you have Internet access at your home?
Any Questions or Other Comments?
By submitting your comment, you give permission for
Dr. Bowman to respond to you via email. No other use of your name or email address
will occur except to respond to any question you raised.