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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 OCUPATIA(DACA SUNT ELEVI,SCOALA SI CLASA)
NASTERII

TIPUL FAMILIEI(SE INCERCUIESTE VARIANTA CORESPUNZATOARE)


Organizata ---DA/NU
Dezorganizata ---DA/NU
In curs de dezorganizare(divort,separare,etc) ---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
___________________________________________________________________________
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LOCUINTA ESTE
Proprietate personala ---DA/NU
Inchiriata ---DA/NU
A bunicilor ---DA/NU
A altor rude ---DA/NU
De tip social ---DA/NU
Este casa ---DA/NU
Este apartament ---DA/NU
Are ____camere si ___bai
Are curte ---DA/NU
Are etaj/mansarda ---DA/NU

Copilul are camera proprie ---DA/NU


O imparte cu fratele /sora ---DA/NU

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

Biblioteca Dictionare
Calculator Enciclopedii
Imprimanta Culegeri(altele decat cele de la
scoala)
Scanner Insectar
Aparat foto digital jucarii
Camera video Jocuri pe calculator
Internet 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?
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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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