Student Survey

If I have your e-mail address, you will receive this student information survey as an attachment in an e-mail. If you did not give me your e-mail address, you may copy and paste this survey into either a Word document or an e-mail, fill it out, and e-mail it to me. Remember to save it as a Rich Text document (rtf). Do NOT leave your answers in a comment!
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Name:

Phone #:

Address:

Parents names:

Parents’ phone #s:

1. Do you have a job? If so, what do you do? What hours do you work?

2. Your favorites:
1. Movie?
2. Song?
3. TV show?
4. Restaurant?

3. What time do you go to bed during the school year?
4. On a scale of 1 to 10 (with 10 meaning a LOT), answer the following:
1. How much do you like to read?
2. To write?
3. Science?
4. Math?
5. What are your hobbies?
6. Your Future
1. What are your future goals?
2. Do you plan on going to college? If so, where?
3. What do you want to study?
4. What is your dream job?
7. What grade do you expect to earn in this class?
8. Three words that describe you:
1. –
2. –
3. –
9. One object that best represents you is ________________ because
10. One thing teachers should know about you is
11. The most influential person in your life is ________________ because
12. One academic goal that you have for this school year is
13. One personal goal that you have for this school year is
14. Where have you traveled?
15. Where have you lived?
16. What would you like to learn in this class?