Student Information Form
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What junior high school did you attend? *
First Name *
Last Name *
ID # *
Class Period *
Birthdate *
Example: January 16, 1981
Age *
Example: 16
Parent/Guardian's name(s) and phone number *
Miki Langi - 817.571.0271 and/or Jake Langi - 817.571.0272
Who are the adults that live in your home? *
Check all that apply.
Required
What is the primary language spoken in your home? *
Favorite subject in school *
Least favorite subject in school *
What extra curricular activities are you involved in on campus? *
•Tell me about a teacher you really liked and what he/she did that you appreciated *
•Tell me about a teacher that you felt wasn't effective and why *
What do you think makes a "good" teacher? *
Describe the most challenging class or unit of study *
How do you like to get feedback? *
On a scale of 1-5, how much do you like reading? *
1: not at all, 2: sort of/sometimes, 3: most of the time, 4: I like reading, 5: I LOVE reading
On a scale of 1-5, how would you rate your reading skills? *
1: I'm a terrible reader, 2: I'm not a very good reader, 3: I'm an ok reader, 4: I'm a good reader, 5: I'm a really, really good reader
On a scale of 1-5, how would you rate your writing skills? *
1: I'm a terrible reader, 2: I'm not a very good reader, 3: I'm an ok reader, 4: I'm a good reader, 5: I'm a really, really good reader
Outside of school, who do you think believes in you and supports you most? *
Who do you want me to tell when you do really well in school? *
Tell me about something that's been hard for you in your life *
Tell me about something you feel proud of *
Tell me about something you love doing that has nothing to do with school *
If you could have three wishes, what would they be? *
What is your goal grade for my class for the first six weeks? *
What is your goal grade for my class for the second six weeks? *
Who was your English teacher last trimester? *
Have you failed any of the following tests? *
Check the last box if you passed EOC I but have not taken EOC II.
Required
What part of the ELA EOC II do you think is the most difficult:? *
What part should we spend the most time on in class? Check ALL that apply.
Required
Can you attend after school tutorials? *
Trinity offers a "late" tutorials bus which leaves at 5:00 on Mondays and Wednesdays.
What three words best describes  you? *
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