Student Survey

Student Name: ________________________________________________________

Please answer these questions. This will help me get to know you and what you like to do.
Circle the answer that best describes you or write your answer.

ead
f t e n d o you r
ect Ho w o
f a v o r ite subj e?
s your at hom
What i
ol?
in scho Never/R
arely
Writing About how m
R e a d in g any ti m e s per wee
k
1-3
Math dies
Social Stu books… e s per we
ek
ti m
Science 4-7
do you own? ____
____
Are in your hous
e? ________
Do you have a computer with have you read in
the last
internet at home? month? ________

Yes No
e
To read books with someon
I like: Someone to read to me
To read books by myself

What would you

like to do better
as a
reader? __________
____________________
What d ________
o you d
you do o when ____________________
you rea ____________________
______
not kno
w? d a wo
rd ________
______ ____________________
______ ____________________
______ ______ ________
______ ______
______ __ ____________________
______ ____________________
______
______ ______
__ ________
______
______
books is:
One of my favorite
______
__

___________
__________________
___________
__________________

Created by Megan Starnes. Visit my TpT store for more ESL activities: http://www.teacherspayteachers.com/Store/Megan-Starnes

Clip art from The 3AM Teacher: http://www.teacherspayteachers.com/Store/The-3am-Teacher

 My favo
you rite TV show
o f t en do ________ is:
Ho w es
________
movi
________
o r ________
h TV ____
watc
_
day?
each
end
c h t im e do you sp
N on e How mu
?
ur e o g a m e s each day
1/2 ho playing vid
urs
1 -2 h o N on e
rs
o re hou
3o r m 1/2 hour
1-2 hours
urs
3 or more ho
Whe
n I am
at h
_____ ome When
_____ , I li I am
_____ ke to with
_____ my fr
_____ ______ iends
_____ _____ _______ , I lik
_____ ___ e to
_____ _______
_____ _______
_____ _____ _______
_____ ____ _______ ______
_____ _______
_____ _______
_____ _______
_____ ______
____ _______
_______
_______
_______
_______ ______
_______
_______
_______
______
When I grow up I would
like to
I am good at
___
______________________________ ________________
____
___
______________________________ ________________
____
___ ________________
______________________________ ____
________________
____
__
______________________________ ________________
____
________________
____

Created by Megan Starnes. Visit my TpT store for more ESL activities: http://www.teacherspayteachers.com/Store/Megan-Starnes

Clip art from The 3AM Teacher: http://www.teacherspayteachers.com/Store/The-3am-Teacher