University of Puerto Rico in Humacao

English Department
Adopted by: Samantha Rodrguez
EDFU 3045 Participant Observation in Classrooms

____________________
(Date)

Dear student:
I am soliciting your cooperation to complete this questionnaire. The purpose of it is
to utilize it as a reference for a study that we will be preparing as a requirement for the
course that we are taking in the University of Puerto Rico in Humacao.
We are interested in learning more about our students interests and preoccupations
to effectively contribute to their academic development. All of the information that you
share with us will be used with strict confidentiality and with the single purpose of using it
for the study mentioned above.
We appreciate your cooperation and for promptly returning this questionnaire.
Cordially,

_____________________________
Group Profile Questionnaire
Student Name: ________________________________

Gender: _______

Grade: ____

Age: __________

Date of Birth: _____________________

Address: ____________________________________________________________
Housing:

___a) own house

____b) rented house

Town where you were born: _____________________________________________

Who do you live with?

___a) father and mother

____c) mother

___b) father

____d) others

Number of family members: __________

Fathers Name: _______________________________
Occupation: ____________________________
Mothers Name: _______________________________
Occupation: _____________________________

Age: ________
Education: __________
Age: _________
Education: __________

What are your favorite television programs?

a) ______________________ b)_____________________ c) _____________________
What is your favorite sport? __________________________________________________
Do you use the school library?

______Yes

_______No

Do you own a computer at home? ______Yes

_______No

What class do you like the most? ____Spanish ____ English

____ Mathematics

____Social Studies _____Science

What class do you like the least? ____Spanish ____ English

____ Mathematics

____Social Studies _____Science

What would you like the study in the future? _____________________________________
What class do you find most difficult? __________________________________________
What class do you find least difficult? __________________________________________
You like to:

______read,

______ listen to music,

_______ paint,

_______ study

What is your hobby? ________________________________________________________

What form of transportation do you use to go to school? ___________________________
Do you use glasses?

________ Yes

_______No

Do you suffer from any illness? Which ones:

a)______________________ b) ____________________ c) _____________________
Do your parents go to school reunions?

_______Yes

Do your parents help you with homework? ______Yes

Letter and questionnaire prepared by: Dr. Carlos Bez

Translated by: Samantha Rodrguez

_______No
_______No