Mr. Eiben's Student Survey
Please complete this survey to tell me a little more about yourself!
Email address *
First Name *
Your answer
Last Name *
Your answer
Period *
Birthday *
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DD
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YYYY
If you were to describe yourself in ONE WORD, what would it be? *
Your answer
What do you like to do for FUN (outside of school)? *
Describe your preferences in hobbies, music, films, books, television shows, art, exercise, sports ...
Your answer
What are your special TALENTS? What comes easy for you? *
Example: Things that you are good at or like doing
Your answer
Tell me about your family! What is life like at home? (For example: "I live with _____. I have ___ brothers, ___ sisters, ____ pets. As a family, we do _____ together.") *
Your answer
Who helps you with assignments that you work on outside of school? *
Your answer
What are your GOALS for the future? What do you want to BE when you grow up? Why? *
Example: Go to college, get a job, join the armed services, etc.
Your answer
What is your FAVORITE SUBJECT in school? Why? *
Example: Science, English, Math, P.E., History, etc.
Your answer
What is your LEAST FAVORITE SUBJECT in school? Why? *
Example: Science, English, Math, P.E., History, etc.
Your answer
What will DISRUPT your ability to learn? *
Your answer
What are your "pet peeves" (things that make you upset or "triggers") when learning? For example: "I don't like it when the classroom is ______." or "It makes me mad when I can't ________." *
Your answer
Just For Mr. Eiben
Is there anything else Mr. Eiben should know about YOU?
Your answer
What would you like to know about Mr. Eiben?
Your answer
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