Independent Reading Survey

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Please complete all of the questions below. For questions that require a written response, please do so in complete sentences or paragraphs where indicated.

Last Name *

First Name *

What is the title of your book? *

Why did you choose this book? *

Recommended from a friend or family member

Researched the Title/Author

Random choice from the list

Always wanted to read the book

I read it before and wanted to double-dip (only choose if you want to fail the activity!)

Other:

Did the cover play any part in your choice? *

Yes

Did the author play any part in your choice? *

Yes

Predict some part of the action that will take place in the story (paragraph format). *

Please explain why you believe this will happen in the story.

Submit

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