Student/Parent Survey

Student Name: ___________________

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Class Period:

1. My favorite subjects are ______________________________________________

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2. My hobbies are _____________________________________________________
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3. After school I _______________________________________________________
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4. I wish I could _______________________________________________________
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5. I would like to meet _________________________________________________
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6. When I am older ____________________________________________________
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7. My family is ________________________________________________________
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8. The most important thing to me is ______________________________________
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9. My goals for this year are ______________________________________________
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10.
I am happy when ____________________________________________________
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11.
I do not like _________________________________________________________
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12.
A great thing about me is ______________________________________________
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13.
I think my teachers should know that I ___________________________________
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Parent, please fill out the rest:

1. The best phone number for me is _______________________________________.
2. One thing you should know about my child is ______________________________

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3. What are two goals you would like to set for your child this year? ______________
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Parent Signature: ____________________________________

Date: _________________