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Confidential Page 1 of 25 Name___________________________________ Questionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your interests, what you like about school, where you think you might need help in school and what your teacher can do to help you work better in school. For most of the answers you only have to circle words, sentences, numbers or letters so read the instructions carefully. Some instructions will have explanations and examples as well. A In this part we ask you questions about what you like to do for fun and what your interests are. This is also your chance to tell the teacher something special about YOU! 1. What do you want your teacher to know about you? 2. When you have nothing to do what would be your first choices to pass the time? Circle three. a. Build forts – with snow or branches or tables & cushions b. Build with Lego or other kinds of bricks c. Draw pictures, paint, make things with clay or sculpey. d. Go bowling. e. Go exploring on a bike. f. Go for a walk with friends g. Go on Face book h. Go shopping i. Go swimming. j. Go to a movie k. Hang out with friends l. Listen to music m. Make music n. Make up plays o. Play a sport with friends. Which sport? _________________________ p. Play basketball in the park or a yard. q. Play on a Wii r. Play with an X box. document.doc Created by Diane Scaiff
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Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

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Page 1: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 1 of 20 Name___________________________________

Questionnaire for Elementary StudentsThese questions are to help your teacher understand a little bit more

about you, your interests, what you like about school, where you think you might need help in school and what your teacher can do to help you work better in school.

For most of the answers you only have to circle words, sentences, numbers or letters so read the instructions carefully. Some instructions will

have explanations and examples as well.

A In this part we ask you questions about what you like to do for fun and what your interests are. This is also your chance to tell the teacher something special about YOU!

1. What do you want your teacher to know about you?

2. When you have nothing to do what would be your first choices to pass the time? Circle three.

a. Build forts – with snow or branches or tables & cushionsb. Build with Lego or other kinds of bricksc. Draw pictures, paint, make things with clay or sculpey.d. Go bowling.e. Go exploring on a bike.f. Go for a walk with friendsg. Go on Face bookh. Go shoppingi. Go swimming.j. Go to a moviek. Hang out with friendsl. Listen to musicm. Make musicn. Make up playso. Play a sport with friends. Which sport? _________________________p. Play basketball in the park or a yard.q. Play on a Wiir. Play with an X box.s. Play tag, statues or other outdoor gamest. Play with games on a computer.u. Read a book.v. Skate: Ice or Roller Blade?w. Something not on this list – please write it down. ______________________x. Text friends.y. Watch television.z. Write

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Page 2: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 2 of 20 Name___________________________________

3. What is your favourite thing to do whena. The weather is really hot?

b. It’s raining hard outside?

c. It’s cold and snowy outside?

4. Do you like to play: a. on your own b. with one or two other kidsc. with a big group of kids?

5. What are your three favourite TV shows?

6. What do you think makes a good TV show?

7. What are your three favourite books?

8. What do you think makes a good book?

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Page 3: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 3 of 20 Name___________________________________

B This part is about your thoughts and feelings on you and school.Circle the number that shows how much you agree or disagree with these sentences.

For example, if the sentence is:Kids should be allowed to eat as much candy as they want.

1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opiniono If you agreed somewhat that kids should eat as much candy as they

want, then you would circle 6 or 7. o If you completely disagree that kids should be allowed to eat all the

candy they want, you would circle 1 or 2. o If you thought that kids should be allowed to eat as much candy as

they want, you would circle 9 or 10. o You can circle 5.5 if you have no opinion on whether kids should be

allowed to eat as much candy as they want or you are not sure whether it is a good idea.

Now answer these questions. There is no right or wrong answer; it is just your opinion.

9. My printing is very good.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

10. I could get better marks if I tried.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

11. I enjoy most of the schoolwork.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

12. I’m a good student.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

13. I’m really awful at schoolwork.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

14. It is hard to concentrate on schoolwork.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

15. Kids should only get homework in high school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

document.doc Created by Diane Scaiff

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Confidential Page 4 of 20 Name___________________________________

16. My parents should help me more with my homework.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

17. My teacher usually explains new work well.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

18. My homework is too hard to do on my own.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

19. I love to read.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

20. School is sometimes difficult for me.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

21. Schoolwork is easy.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

22. My handwriting is neat.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

23. The teacher gives us too much homework to do.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

24. When my assignment is difficult, I like to ask for help right away.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

25. I prefer to work on my own on assignments.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

26. I like to study.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

27. Schoolwork is usually boring.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

28. Homework is easy to get done quickly.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I am proud of my tidy desk at school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

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Confidential Page 5 of 20 Name___________________________________

It’s hard to keep my arithmetic in straight lines.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

29. The things we do in school are fun. 1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

30. Schoolwork is too hard.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

31. We learn interesting things at school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

32. Difficult schoolwork is fun to figure out.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Easy schoolwork is boring.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I like school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My teacher is too strict.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

School is usually fun.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

39. I like working in groups.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

40. The kids in my class are nice.1 2 3 4 5 5.5 6 7 8 9 10

Strongly Disagree Don’t Know Strongly AgreeI have no opinion

document.doc Created by Diane Scaiff

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Confidential Page 6 of 20 Name___________________________________

C This is also about school, but more about what works best for you and how you think a classroom should be.

I pay attention when the teacher is explaining the work.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

It’s hard to understand when my teacher explains new work.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

When I am doing schoolwork, I want to get up and walk around every few minutes.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

42. It’s really hard to start my writing at the margin every time.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

43. Bullies are a serious problem in our school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Bullies often do things behind the teacher’s back.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Cleaning the classroom should be our job.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Gum chewing should be allowed in school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I can work easily in a noisy classroom.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I like a quiet classroom when I am trying to get work done.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I like having my own desk.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My desk at school is so messy that I sometimes have trouble finding things.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My teacher usually has time during class to help me.1 2 3 4 5 5.5 6 7 8 9 10

document.doc Created by Diane Scaiff

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Confidential Page 7 of 20 Name___________________________________

Strongly Disagree Don’t Know Strongly AgreeI have no opinion

Sitting in groups at the same table is better than sitting on your own at a desk.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Students need breaks to shake their sillies out.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Students should help keep the classroom clean and tidy1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

There are too many kids in my class.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Asking questions in class is difficult for me.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

At school I find it hard to concentrate.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

document.doc Created by Diane Scaiff

Page 8: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 8 of 20 Name___________________________________

D Again, more about you and school, but this time we want to know what you think of behaviour in the school – yours, other students’ and your teachers’.

Circle YES, NO or N/A (not applicable) for each sentence. For example if the question was:

Cooking is my favourite class. YES NO N/A,You have three possible answers:

If cooking IS your favourite class, then you circle: YES If cooking is NOT your favourite class, then you circle: NO If you DO NOT TAKE cooking classes, then you circle: N/A (not

applicable)

60. If everyone talked quietly, the classroom would be very noisy. YES NO N/A

It’s hard to get help from my teacher during class. YES NO N/A

Kids who misbehave in class get off too easily. YES NO N/A

Rows of desks with a desk for each person is a good way to have a classroom. YES NO N/A

Some of the students in our class talk too much. YES NO N/A

The teachers usually figure out who the bullies in our school are. YES NO N/A

We should be allowed to pass notes when the teacher isn’t talking. YES NO N/A

We should be allowed to talk quietly while we are working. YES NO N/A

When the classroom is noisy I find it difficult to work. YES NO N/A

Even when I hurry, I am one of the last to finish work in the classroom.YES NO N/AI am always losing

things. YES NO N/A

I am always one of the first to finish work in the classroom. YES NO N/A

document.doc Created by Diane Scaiff

Page 9: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 9 of 20 Name___________________________________

E Now we want to know what you think of your marks and what you think makes a difference between good marks and bad marks.Circle the number that shows how much you agree or disagree with these sentences. 10 means Agree completely.

7 or 8 means Agree, but not completely 1 means Disagree Completely. 3 or 4 means Disagree, but not completely 5.5 means I haven’t really thought about it, I have no opinion or I

don’t knowAssignments should be done well.

1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I work very hard at school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Girls are the only ones who get good marks in our class.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I worry about my marks.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Students should be rewarded for good marks on report cards.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Students should be taught how to study.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

If I studied, I would get good marks on tests.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My marks are bad because my teacher hates me.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My parents care more about the learning skills than the marks for my subjects.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My parents expect me to get good marks.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

document.doc Created by Diane Scaiff

Page 10: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 10 of 20 Name___________________________________

My report card marks are usually fair.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My parents think my marks are too low.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My parents should go to parent-teacher meetings without me.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

No matter how much I study I still don’t get good marks on tests.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Parent-teacher meetings are important to my parents.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Studying makes my marks better on tests1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Tests usually make me nervous.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

F Everyone has favourite subjects, and we do want to know yours, but we also want to know why some subjects are your favourite and others are your absolutely least favourite. If you have more to say about subjects than these questions allow, please write down what you think after doing the questions.

Circle YES, NO or N/A (not applicable) for each sentence.

Art is fun when we make things. YES NO N/A

Drawing pictures of experiments is fun. YES NO N/A

I enjoy writing what I think. YES NO N/A

I get bored when the teacher tells us about people who lived long ago.

YES NO N/A

I like it when our teachers read to us. YES NO N/A

document.doc Created by Diane Scaiff

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Confidential Page 11 of 20 Name___________________________________

I like learning about how to make art: things like using perspective and the colour wheel.

YES NO N/A

I like learning different sports in gym. YES NO N/A

I like looking at art made by famous artists. YES NO N/A

I think spelling is easy. YES NO N/A

I wish I could write my ideas down faster. YES NO N/A

I would like gym better if we could choose the games ourselves.

YES NO N/A

Ideas in math are very interesting. YES NO N/A

It’s hard to for me to write sentences on the lines. YES NO N/A

It’s hard to read quietly for very long. YES NO N/A

Language arts would be good if it were easier to write neatly.

YES NO N/A

Learning about things that happened a long time ago is exciting.

YES NO N/A

Learning French is too difficult. YES NO N/A

Math facts are hard to remember. YES NO N/A

Music would be better with instruments. YES NO N/A

Pictures and diagrams are difficult for me to draw properly.

YES NO N/A

Quiet reading time is a good part of the day. YES NO N/A

Reading might be more fun if I could do it faster. YES NO N/A

Science experiments are often interesting. YES NO N/A

Singing is my favourite part of the week. YES NO N/A

Reading might be more fun if I could remember what I had just read.

YES NO N/A

Speaking French is

fun. YES NO N/A

Spelling is hard. YES NO N/A

The worst part of music is singing. YES NO N/A

We have to learn French so we can get a good job. YES NO N/A

document.doc Created by Diane Scaiff

Page 12: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 12 of 20 Name___________________________________

F Most people do homework but everyone does it in their own way. We would like to know what your special way is, if you have any problems, what you think of it and from that your teachers might be able to think of a way to help.

Circle the number that shows how much you agree or disagree with these sentences. 10 means Agree completely. 1 means Disagree Completely. 5.5 means I haven’t really thought about it, I have no opinion or I don’t know.

Homework is important.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Homework would be boring without friends to talk to on the phone or the Internet.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

122. I don’t do difficult homework.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

123. I always study for tests.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I do my assignments carefully.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I have a hard time waking up in the morning. 1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I use spare time in class to do homework.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

125. I usually finish all my homework on time.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

I wish my parents would help me with my projects.1 2 3 4 5 5.5 6 7 8 9 10

document.doc Created by Diane Scaiff

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Confidential Page 13 of 20 Name___________________________________

Strongly Disagree Don’t Know Strongly AgreeI have no opinion

It takes too long to get my homework done.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

126. I usually watch television before I do my homework. 1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Homework helps me understand what I learn at school.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My house is usually quiet when I do homework.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My parents expect me to do chores most days.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

My parents will help me with schoolwork if I ask them.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Texting, tweeting and chatting on line or on the phone are ways of kids helping each other with homework.

1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

There isn’t enough time in the evenings to get my homework done.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Usually no one reminds me to do homework.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

Without my parents’ help, school projects would be too difficult to do.1 2 3 4 5 5.5 6 7 8 9 10Strongly Disagree Don’t Know Strongly Agree

I have no opinion

document.doc Created by Diane Scaiff

Page 14: Questionnaire for Elementary Students - … · Web viewQuestionnaire for Elementary Students These questions are to help your teacher understand a little bit more about you, your

Confidential Page 14 of 20 Name___________________________________

G Work habits are some of the tools we use to learn and later on in life when we get jobs. If we learn good work habits, we can get things done better and more quickly. By answering these questions, you will be helping your teachers understand which work habits you have and which ones you need to learn.

Circle YES, NO or N/A (not applicable) for each sentence.

At home I always listen to music while I do homework. YES NO N/A

Even when my teacher is really nice, it is still difficult for me to ask questions in class. YES NO N/A

I am not allowed to use my cell phone while I am doing homework. YES NO N/A

I can only use the Internet when my parents say so. YES NO N/A

I do my homework when and where I want to. YES NO N/A

I get up to have a snack while I am doing homework. YES NO N/A

I talk to friends while I do homework. YES NO N/A

I have a cell phone and text friends while I do homework. YES NO N/A

I have a computer in my room. YES NO N/A

I have a computer where I do homework. YES NO N/A

I have a desk in my room but I usually work somewhere else in the house. YES NO N/A

I have a desk in my room for homework. YES NO N/A

I have to do my homework at the time my parents decide. YES NO N/A

I like to do my homework while I watch TV. YES NO N/A

I like to study. YES NO N/A

I never show my parents my homework. YES NO N/A

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Confidential Page 15 of 20 Name___________________________________

I often ask questions in class when I need help with the work. YES NO N/A

I share a room with a brother or sister who is not in school yet. YES NO N/A

I usually do homework on my bed or the floor. YES NO N/A

I wake up before the alarm clock every morning. YES NO N/A

It takes me a long time to get my homework done. YES NO N/A

It’s better to get homework done at school. YES NO N/A

My friends sometimes copy my homework answers. YES NO N/A

My homework gets done most of the time. YES NO N/A

My house is often noisy when I am doing my homework. YES NO N/A

My parents insist on a quiet time for homework. YES NO N/A

My parents make me use the desk in my room to do homework. YES NO N/A

My parents make us work at a table in the kitchen or the dining room.YES NO N/A

My parents rarely ask about my homework. YES NO N/A

My parents usually supervise my homework. YES NO N/A

School would be boring if I didn’t work. YES NO N/A

Sometimes I forget my homework at school. YES NO N/A

The desk in my room is too messy to do my homework on.YES NO N/A

The library is my favourite place to do homework. YES NO N/A

The most important thing is to get an assignment finished. YES NO N/A

Usually I don’t do all my homework. YES NO N/A

When I don’t understand something, I try to figure it out before I ask questions. YES NO N/A

When I work hard I eventually understand even difficult schoolwork. YES NO N/A

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Confidential Page 16 of 20 Name___________________________________

While I do homework I text, tweet, chat on-line or talk to my friends on the phone. YES NO N/A

127. My parents make me do my homework over again if they think it is not done well enough. YES NO N/A

H Circle the sentences that best describe your social life at school.

I have a few friends but we spend a lot of time together.I have lots of friends.I have no friends.I have one very good friend

I belong to a club(s). Please list:

I don’t do sports.Sports and clubs don’t interest me.I do extra-curricular sports. Usually (list them, please)

I eat lunch at school.My parents give me money to buy lunchI make my own lunchI don’t eat lunch if I can avoid itMy mom or dad make my lunchIt’s usually OKIt’s usually really goodI usually throw out part of my lunch or trade it

Eating lunch at school is OK.

I prefer eating lunch at school because:I can be with my friendsI can do sports or clubsI can get extra helpI can go to the school libraryOther – please explain

I don’t like eating lunch at school because: I don’t like going outside at recess except in warm weather.There isn’t much to do afterwards

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Other – please explain

I go home for lunch.

Going home for lunch is better because:I get a real break from school I get to watch TV or play gamesIf I have forgotten something I can get it.The lunchroom is too noisy.The food is better at homeThe bathrooms at school are too dirtyOther – please explain______________________________

I would rather not go home for lunch because:I have to do chores (such as walk a little sister home or help in the family business)I can’t do sports or clubs at school.There isn’t enough time to do anything except eat lunch.I don’t have time to play with my friends.

128. a. I usually read at recess.If we didn’t have recess I couldn’t survive school.Recess is fun because I get to play with my friends. Staying in to help the teacher is the best thing to do at recess.

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I These are the last set of questions. They are about what you think of life in general; what we call your philosophy of life. You just have to check the sentences that you most agree with. You don’t have to COMPLETELY agree with them, but if you agree with them most of the time, check them off. Ignore sentences you don’t agree with. There is an example below:

Check the sentences that you agree with most or you think best describe how you think or feel. For example, if you had the following six sentences:

1.I like worms. 2.Dogs are more fun than cats. 3.Red is best. 4.Teachers look better in black pointy hats.

5.I eat two chocolate bars with my breakfast. 6.Spiderman is my brother.

And you really enjoyed having worms and chocolate bars for breakfast with your brother, Spiderman, but you don’t care what teachers wear, think dogs are boring and like the colour yellow, you would check the boxes for 1, 5 and 6. Like this:

1.I like worms. 2.Dogs are more fun than cats. 3.Red is best. 4.Teachers look better in black pointy hats.

5.I eat two chocolate bars with my breakfast. 6.Spiderman is my brother.

Check the sentences that you agree with most or you think best describe how you think or feel.

193. I am a good person. 194. Angry people scare me. 195. Annoying people should be ignored.

196. Parents are really busy. 197. Being good-looking is not important.

198. Being nice is different from being good.

199. Being smart in school can be embarrassing.

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200. Cheating on tests is wrong. 201. Copying from the Internet is research.

202. Everyone hates me. 203. Everyone in my family works hard 204. Hardly anybody really wants to be good.

205. Helping other people makes me feel good. 206. Some of the kids at school are mean.

207. Kids want to be good people.

208. Parents are not much help to their kids. 209. It’s fine to cheat on schoolwork.

210. I get angry a lot.

211. I have more good luck than most people. 212. I occasionally say sarcastic or mean things to annoying kids. 213. I think it is kind of funny when I make someone else angry.

214. I try to do the right thing. 215. I wish I were better looking.

216. Teachers care about kids

217. You should fight back when somebody hurts you. 218. If I do something wrong, I try not to do it again. 219. It’s OK to steal from a big company.

220. It is really important to be good-looking. 221. It’s wrong to copy from the Internet.

222. It’s usually people’s fault if they are poor.

223. Kids have a good life. 224. I am often unhappy. 225. Life is so much fun.

226. Lying about bad people is OK. 227. Most of the time I am happy 228. Most people like me.

229. My family is smarter than most people. 230. My friends are terrific. 231. Nice people are usually good people.

232. Only smart kids get good marks. 233. Peace at any price is my motto. 234. Being a kid is hard.

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235. Parents do their best to help their children. 236. I am smart in school. 237. Sometimes I behave badly in class.

238. Sometimes it is hard to do the right thing. 239. Sometimes people can be very annoying. 240. Stealing is wrong.

241. Students who get bad marks aren’t working hard enough. 242. I wish I were smarter. 243. Teachers like kids.

244. There is a difference between making a mistake and doing something bad. 245. The teachers are mean to me.

246. Very few people are better looking than me.

247. When I make a mistake, I usually say I am sorry. 248. When other kids are annoying, I want to hit them. 249. When kids get bad marks, it is because they don’t have a good teacher.

250. I’m good-looking enough. 251. Stealing small things like pencils or dimes isn’t bad.

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