All About You

Since we will be together for the rest of the trimester, I am asking you to complete
this survey in order for me to get to know you a little better.

What is your name?_____________________________________________________________

What is your favorite hobby? _____________________________________________________
How many books are in your home? (including electronic) ______________________________
What is your favorite genre to read? ________________________________________________
What is your favorite book or who is your favorite author? ______________________________
_____________________________________________________________________________
How many hours do you spend per WEEK reading?
a. 0
c. 4-6
b. 1-3
d. 6+
How many hours do you spend per WEEK writing?
a. 0
b. 1-3

c. 4-6
d. 6+

How many hours per DAY do you spend watching TV?

a. 0
b. 1-3

c. 4-6
d. 6+

How many hours per DAY do you spend on the internet?

a. 0
b. 1-3

c. 4-6
d. 6+

How many hours per DAY do you spend playing video/computer games?
a. 0
b. 1-3

c. 4-6
d. 6+

What do you like to read? ________________________________________________________

______________________________________________________________________________
______________________________________________________________________________
Do you speak/read/write any other languages? If so, what ones? __________________________
______________________________________________________________________________

How do you learn best? (watching, listening, reading, hands on, etc) ______________________
_____________________________________________________________________________
How do you define literacy? ______________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
When is your birthday? __________________________________________________________
What kinds of technology do you use on a weekly basis? _______________________________
_____________________________________________________________________________
_____________________________________________________________________________
List 3 words that best describe you? ______________________
_______________________

__________________________

What would you like me to know about you as a reader/writer/student? ____________________

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Is there anything else I should know about you? ______________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Anything else you want to add?