Student Questionnaire
Welcome to our class! Please fill out this questionnaire
so that I can teach you better. Thank you!
General Questions:
Name:_________________________________________ Period:____
Nickname you would like to be called: ________________________
Date of birth:______________________________________________
Home phone number:_______________________________________
Home email: ______________________________________________
Parent’s/guardians’ names:__________________________________
_________________________________________________________
Who would you like me to tell when you do something especially well? ________________________
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Do you have any allergies? If so, please explain. ___________________________________________
_____________________________________________________________________________________
About your activities and interests:
What do you do after school? ____________________________________________________________
_____________________________________________________________________________________
What are your other interests? ___________________________________________________________
_____________________________________________________________________________________
About the way you learn:
Who is your favorite teacher? Why? _______________________________________________________
_____________________________________________________________________________________
Do you like science? Why or why not? _____________________________________________________
_____________________________________________________________________________________
What would you really like to learn in this class? ___________________________________________
_____________________________________________________________________________________
Describe the way you learn things best. ___________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Is there anything that could make this class especially hard for you? ___________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Can you think of a way I can help you with this? ____________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Favorites:
What is your favorite candy? ____________________________________________________________
What is your favorite food? _____________________________________________________________
What is your favorite TV Show? __________________________________________________________
What is your favorite type of music? ______________________________________________________
What is your favorite sports team? _______________________________________________________
What is your favorite school subject? _____________________________________________________
MISC questions:
Which characteristics do you respect and admire in a teacher? _______________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
What motivates you? ___________________________________________________________________
_____________________________________________________________________________________
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Is there anything else that you would like me to know? ______________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Your course schedule…
Period
Class – Teacher – Room #
Homeroom
1
2
3
4
Thank you for taking the time to fill out this questionnaire.
We are going to have a great semester together!