Getting to know you
Dear student! We are clinicians from Rutgers who have been doing some training with your teachers to give them some strategies for supporting you in school. In order to best do this, we would like to ask you some questions about your personal experiences. Your answers will remain completely confidential, and we will not be asking for your name to ensure your confidentiality.
Is there anyone at home to help you with your homework? *
What grade are you in? *
On average, how many hours of sleep do you receive per night? *
Your answer
On average, how many hours of homework do you have per night? *
Your answer
On average, how stressed do you feel about school? *
Not Stressed
Very Stressed
How important do you find school academics? *
Not Important
Very Important
How important do you think science is to your future goals? *
Not Important
Very Important
How important do you think math is to your future goals? *
Not Important
Very Important
What are three things that Motivate you to do school work? *
Your answer
What can your teacher do to support you in Math and Science? *
Your answer
What are your grades in Math *
What are your grades in Science *
If you get homework what subjects are you likely to do?(Check all that apply) *
Required
What can the school do to support you? *
Your answer
What activities are you involved in after school? Examples can be extracurricular clubs or sports, work, responsibilities at home, etc. *
Your answer
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