CHESTIONAR PENTRU CUNOASTEREA ELEVULUI

NUME_____________________________________________________________________
PRENUME_________________________________________________________________
DATA NASTERII____________________________________________________________
LOCUL NASTERII___________________________________________________________
CNP
ADRESA___________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
TELEFON____________________________________

PARINTII:
MAMA
NUME_____________________________________________________________________
PRENUME_________________________________________________________________
CNP
STUDII_____________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
PROFESIE__________________________________________________________________
LOC DE MUNCA____________________________________________________________
PROGRAM DE MUNCA______________________________________________________
TELEFON MOBIL___________________________________________________________
TELEFON LOC DE MUNCA___________________________________________________

TATA
NUME_____________________________________________________________________
PRENUME__________________________________________________________________
CNP
STUDII_____________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
PROFESIE__________________________________________________________________
LOC DE MUNCA____________________________________________________________
PROGRAM DE MUNCA______________________________________________________
TELEFON MOBIL___________________________________________________________
TELEFON LOC DE MUNCA___________________________________________________

FRATI/SURORI
NUME

PRENUME DATA
NASTERII

OCUPATIA(DACA SUNT ELEVI,SCOALA SI CLASA)

TIPUL FAMILIEI(SE INCERCUIESTE VARIANTA CORESPUNZATOARE)

Organizata
Dezorganizata
In curs de dezorganizare(divort,separare,etc)

---DA/NU
---DA/NU
---DA/NU

Are _______membri,dintre care:____parinti,____copii minori si ____copii majori,____bunici

materni,____bunici paterni.

COPILUL ESTE:
Natural
---DA/NU
Adoptat
---DA/NU
Al tatalui
---DA/NU
Al sotiei
---DA/NU
Luat in plasament (din anul_________)
---DA/NU
Alte situatii__________________________________________________________________

COPILUL LOCUIESTE
Cu parintii
---DA/NU
Cu bunicii
---DA/NU
Cu parintii si bunicii materni/paterni
---DA/NU
Cu alte rude inclusiv
---DA/NU
Cu alte rude exclusiv,din urmatoarele cauze:
---DA/NU
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

LOCUINTA ESTE
Proprietate personala
Inchiriata
A bunicilor
A altor rude
De tip social

---DA/NU
---DA/NU
---DA/NU
---DA/NU
---DA/NU

Este casa
Este apartament
Are ____camere si ___bai
Are curte
Are etaj/mansarda

---DA/NU
---DA/NU

Copilul are camera proprie

O imparte cu fratele /sora

---DA/NU
---DA/NU

---DA/NU
---DA/NU

ARE COPILUL?(raspundeti cu ,,da sau ,,nu)

Biblioteca
Calculator
Imprimanta
Scanner
Aparat foto digital
Camera video
Internet

Dictionare
Enciclopedii
Culegeri(altele decat cele de la
scoala)
Insectar
jucarii
Jocuri pe calculator
Telefon mobil propriu

VENIT/MEMBRU DE FAMILIE_______________________________ RON

DATE FIZICE SI DE SANATATE
Inaltime......................
Greutate.....................
Probleme speciale de sanatate
.......................................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
Alergii...........................................................................................................................................
.......................................................................................................................................................
.......................................................................................................................................................
.
Copilul urmeaza vreun tratament permanent?
DA/NU
Copilul merge sau a mers la un cabinet :
---de logopedie
DA/NU
---psihologic
DA/NU
---psihiatric
DA/NU

RELATII IN FAMILIE
Copilul este legat afectiv cel mai mult de
Se teme de
Ii place sa stea cel mai mult cu
Asculta cel mai mult de
In cazul in care are nevoie de ajutor,apeleaza deseori la

______________
______________
______________
______________
______________

INDEPLINIREA SARCINILOR SCOLARE SI EXTRASCOLARE

Ii place sa mearga la scoala?
DA/NU
Ii place sa-si efectueze temele?
DA/NU
Efectueaza singur temele?
DA/NU
Daca nu,cine il ajuta?
____________________________
Ce activitati desfasoara in timpul liber?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Ce discipline scolare prefera?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Ce discipline scolare nu ii place in mod deosebit?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Frecventeaza alte cursuri,cercuri scolare sau extrascolare?Daca da,care?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Stie sa utilizeze un calculator?
DA/NU
Daca da,ce anume stie sa opereze?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
Cunoaste limbi straine?
DA/NU
Daca da,ce limba stie?
_____________
Unde a invatat-o?
___________________________
Daca nu,i-ar placea sa stie o limba straina?
DA/NU
Care?
_______________

SPRIJINUL ACORDAT DE FAMILIE ELEVULUI SI INTERESUL

PENTRU SCOALA
Va ajutati copiii la teme?
DA/NU
Aduceti copilul la scoala dimineata?
DA/NU
Luati copilul la pranz?
DA/NU
Ce persoane sunt autorizate sa se ocupe de copil,in afara de parinti?
---bunici
DA/NU
---frati/surori mai mari
DA/NU
---alte persoane(bona,vecini,alte rude,etc)
DA/NU
Cat timp petreceti impreuna cu copilul dvs?________________________
Ce activitati desfasurati impreuna?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
De cate ori verificati carnetul de elev?____________________________________________
De cate ori verificati caietele,lucrarile de control,testele copilului ?
___________________________________________________________________________
Doriti sa participe si la alte activitati din afara scolii?
DA/NU

Doriti sa invete o limba straina?

DA/NU
V-ar placea sa invete o limba straina la scoala inca din clasa a II-a?
DA/NU
Ce suma alocati lunar intretinerii copilului?
_____________RON
Dar strict activitatilor scolare?
_____________RON
Dar activitatilor extrascolare(excursii,proiecte,limba straina,cercuri, etc)?____________RON
Preferati uniforma scolara sau imbracaminte particulara?___________________________
De ce?
___________________________________________________________________________
___________________________________________________________________________
Cum v-ati caracteriza,pe scurt,copilul?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

RELATIA FAMILIE SCOALA

Cat de des va interesati la scoala de situatia copilului dvs?_____________________________
Veniti la fiecare sedinta cu parintii?De ce?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
________________________________________________________________________
Preferati sa primiti informatii despre copil in plenul sedintei cu parintii sau in particular?
___________________________________________________________________________
De ce?______________________________________________________________________
Cate sedinte credeti ca ar fi de folos pe semestru?____________________________________
Cat de des v-ar placea sa discutati cu invatatoarea?
___________________________________________________________________________
Credeti ca este util ca invatatoarea sa va comunice telefonic anumite probleme in legatura cu
copilul,atunci cand este cazul?
DA/NU
Ati fi dispusi sa participati la activitati ale copiilor dvs,impreuna cu ei?
DA/NU
Ce asteptati de la invatatoare in noul an scolar?

SEMNATURA MAMEI ____________________

SEMNATURA TATALUI ____________________

VA MULTUMESC!
Institutor Nicoleta-Florentina Cristea