Student Survey

Nam
e

Period

Date

Name one person you look up to and explain why.

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What excites you about science? What do you like about science?
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What intimidates you about science? What do you not like about science?
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What are your hopes/ plans for the future? If I were to run into you five or ten years
from now, where would you be and what would you be doing?
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Favorites
School
Subject
Book
Movie
TV Show

Snack/ Treat
Singer/
Group
Actor
Activity/
Sport

Do you have
Internet
access?
(Check all that
apply)

_____Home
_____ Cell/ Smart Phone

_____ School
_____ Library

_____ Other:

Check all that apply.

I learn best when.
_____ I hear a teacher explain it verbally
_____ I hear a classmate explain it verbally
_____ I read a written explanation
_____ I see diagrams or drawings
_____ I do hands on activities
_____ I see lots of different examples
_____ I can see how it relates to something I already know
_____ I can ask a lot of questions
_____ the room is silent
_____ there is music playing
_____ I am working alone
_____ I am working with a partner
_____ I am working with a group
_____ the teacher is talking only to me
_____ Other:

Thank you for filling out this survey!! Im looking forward to

working with you in the classroom.