Period ____ Course: ________________ Name: ______________ _________ _____

(First) (Last)
An Autobiography
Filling out this sheet will help me get to know you better. If you find a question too sensitive or you feel

uncomfortable answering it, just leave it blank. Thanks! 

1. Address: ____________________________________________Home Phone #: ___________________
2. a) Birthplace: _____________________________b) Date of Birth______________________________
3. List the people you live with and their names. (Ex. Mom: Jane Smith)
Parents/Guardians: ____________________________________________________________________
Siblings: ____________________________________________________________________________
4. Parent/Guardian Information - Where and when do your parents/guardians work?
Mother/Guardian: _________________________ Father/Guardian: ________________________
Place: __________________________________ Place: _________________________________
Times: __________________________________ Times: ________________________________
Phone #: ____________________________ Phone #: __________________________
Cell #: ______________________________ Cell#: _____________________________
Email: ____________________________________ Email: _________________________________
5. If I need to call home about your progress in school, who would you like me to talk to? Why?
____________________________________________________________________________________
6. List two of your favourite school subjects. __________________________________________________
7. Is there any reason why you may be absent this term? If so, explain. ____________________________
___________________________________________________________________________________
8. What do you like best about school? ______________________________________________________
9. What do you like least about school? ______________________________________________________
10. List three of your interests or hobbies. _____________________________________________________
11. List three school activities you would like to participate in this year. ______________________________
____________________________________________________________________________________
12. If you have a part-time job, fill in the following information.
Place of work: ________________________________________Job title: ________________________
When do you work? ____________________________________
13. Is there anything else you think I should know about you? (i.e. allergies, etc…) _____________________
____________________________________________________________________________________
14. a) What grade did you receive in this course last year? ________________
b) What grade would you like to receive in this course this year? ________________
b) What do you think you have to do to earn this grade? List some work habits that you think will help you
accomplish this. ______________________________________________________________________
____________________________________________________________________________________
15. Complete the following statements.
a) I wonder if _________________________________________________________________________
b) I hope that _________________________________________________________________________
c) I am good at _______________________________________________________________________
 d) A good teacher is someone who _______________________________________________________
Your Timetable – Fill in the following chart with the Subject and Room in each box.
Period 1 Period 2 Period 3 Period 4 Period 5
Subject

Room

TEACHER USE ONLY

DATE PERSONAL NOTES, RECOMMENDATIONS, REASONS FOR PARENTAL CONTACT