Academic Support Program Goal Setting & Survey
Tell us about yourself
What is your name? *
What grade are you in? *
What is your ethnicity? *
What is your gender?
Tell us about your academic performance
Tell us about your SBAC Scores
What is your SBAC Achievement Level score in ELA?
What is your Achievement Level in Math?
Tell us about your daily habits.
Rank the following behaviors from 1 to 5 (1=never, 5=always).
I do my homework daily. *
I put EFFORT into doing my own homework and doing it correctly. *
If I don't understand a concept, I ask questions or ask for help. *
When I am absent, I ask my teacher for make-up work. *
I always come prepared for class (textbook, homework, supplies, other materials). *
I have an agenda/planner that I use to write down my assignments daily. *
I am focused in class. *
I participate actively in class. *
An adult at home checks my homework nightly. *
An adult at home is always encouraging me to do my best in school. *
I can find my assignments easily when they are asked for/due. *
I have a way that I keep my work/papers organized. *
I believe I can accomplish anything I set my mind to. *
I study daily. *
When I study for tests or quizzes, how long do I study for? *
Does some of your homework assignments require the use of a computer?
Do you have a computer at home?
What time do you usually go to sleep at night?
About how much time do you spend playing on your phone or computer each day?
Tell Us About Your Grades & Goals
Why do you think you have the grades you have?
What is your current grade in Reading?
What is your goal in Reading? *
What is your current grade in Math?
What is your goal in math? *
What is your current grade in Social Science?
What is your goal in social science? *
What is your grade in Science?
What is your goal in science? *
What do you think you could do to improve your grades and academic performance?
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