Introducing Your Student
I'd like to know more about your student, through your eyes. The more I know, the better I can tailor an educational and motivational program to fit his or her particular needs.

Please answer the questions and complete the information in the following survey. Feel free to write as much or as little as you need to give me the most comprehensive picture of your student as possible.

If you have more than one student in my classes, please fill out this form once for EACH student. Please know you can email me at any time with additional information at Thank you for your time!
Student's Last Name *
Student's First Name *
English Period *
Parent/Guardian Name(s) *
Primary Contact Email *
1. Please list five words that best describe your student's character. (ex: competitive, cheerful, perfectionist, etc.)
2. What excites or motivates your student?
3. What upsets or discourages your student?
4. What are your student's out-of-school interests and activities?
5. What activities do you share with your student? What problems/successes do you have working/playing together?
6. What English Language Arts skills do you believe are your student's strengths?
7. What English Language Arts skills do you believe are your student's weaknesses?
8. What study skills do you believe your student needs to develop? (time management, organization, note-taking, critical thinking, communication, etc.)
10. What goals do you have for your student this year? What are your student's plans for high school?
10. Which academic subject is your student's best? Worst? Favorite?
11. Does your student have access to a computer with internet access at home? *
Please check all that apply
12. Are there any personal or physical problems I should know (or conference privately) about?
13. Free response - do you have other comments, questions, or concerns or any additional information about your student you'd like to share?
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