Student Survey

Name: _____________ Instruction: write at least one sentence for each

Date: ______________ question. Be sure to fill in your name, date, and period.

Period: ____________

Introduction
What do you prefer to be called?

Name one interesting fact about your family

List your siblings and your relationship to them (brother, sister, etc.)

List 3 words your friend would use to describe you

List 3 things you SUPER enjoy (hobbies or interest is fine)

Reading Survey
How often do you read? Circle one of the numbers. 1 = not often / 10 = often.

1 2 3 4 5 6 7 8 9 10
Do you enjoy reading? Circle one of the numbers. 1 = dislike / 10 = like.

1 2 3 4 5 6 7 8 9 10
How high do you consider your reading level? Circle one of the numbers. 1 = low / 10 = high.
1 2 3 4 5 6 7 8 9 10

Writing Survey
How often do you write? Circle one of the numbers. 1 = not often / 10 = often.

1 2 3 4 5 6 7 8 9 10
Do you enjoy writing? Circle one of the numbers. 1 = dislike / 10 = like.

1 2 3 4 5 6 7 8 9 10
How high do you consider your writing level? Circle one of the numbers. 1 = low / 10 = high.

1 2 3 4 5 6 7 8 9 10

This class
What do you like about Language Arts?

What do you dislike about Language Arts?

What do you think you’ll learn from this class?

What would you like to learn in this class?