Confidential Student Self-Inventory and Assessment Report

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SSS

Email *

I am confident that an education will benefit my life *

Often

Sometimes

Rarely

Never

Major

Name *

W# *

Classification

Freshman

Sophomore

Junior

Senior

Clear selection

Gender

Male

Female

Prefer not to say

Other:

Clear selection

1.) I have trouble picking out the important points in material when I read or study.

Often

Sometimes

Rarely

Never

Clear selection

2.) I find it hard to keep my mind on what I'm studying.

Often

Sometimes

Rarely

Never

Clear selection

3.) I regularly have to wait for the "mood to strike" or for an inspiration before I can start a task.

Often

Sometimes

Rarely

Never

Clear selection

4.) I find myself too tired, sleepy, or listless to study effectively.

Often

Sometimes

Rarely

Never

Clear selection

5.) My time is unevenly distributed. I spend too much time on some things and not enough time on others.

Often

Sometimes

Rarely

Never

Clear selection

6.) I miss important points in the lecture while taking notes on something previously mentioned.

Often

Sometimes

Rarely

Never

Clear selection

7.) I fall behind in my studies.

Often

Sometimes

Rarely

Never

Clear selection

8.) I get nervous during exams: blank out, panic, and/or feel nauseated.

Often

Sometimes

Rarely

Never

Clear selection

9.) My periods of study are regularly interrupted by outside interference such as telephone calls, friends, family, and/or distracting noises.

Often

Sometimes

Rarely

Never

Clear selection

10.) I find myself waiting until the last minute to finish a report/project/paper.

Often

Sometimes

Rarely

Never

Clear selection

11.) My social life is as equally important as school, even if it interferes with my academic success.

Often

Sometimes

Rarely

Never

Clear selection

12.) I have a tendency to daydream while trying to study.

Often

Sometimes

Rarely

Never

Clear selection

13.) Dislike of certain courses/teachers interferes with my attitude and school success.

Often

Sometimes

Rarely

Never

Clear selection

14.) I plan out the answer to an essay exam question in my mind before writing it on the exam.

Often

Sometimes

Rarely

Never

Clear selection

15.) I try to carry over facts learned in one course to another.

Often

Sometimes

Rarely

Never

Clear selection

16.) I schedule my study time.

Often

Sometimes

Rarely

Never

Clear selection

17.) I am influenced by my friends on when to study.

Often

Sometimes

Rarely

Never

Clear selection

18.) Cramming before a test is the only thing that works for me.

Often

Sometimes

Rarely

Never

Clear selection

19.) I feel my knowledge of today's technology is adequate.

Often

Sometimes

Rarely

Never

Clear selection

20.) I feel concerned about my chosen career.

Often

Sometimes

Rarely

Never

Clear selection

21.) I am comfortable around people.

Often

Sometimes

Rarely

Never

Clear selection

22.) I feel work-related stress.

Often

Sometimes

Rarely

Never

Clear selection

23.) I feel like a failure.

Often

Sometimes

Rarely

Never

Clear selection

24.) I make friends easily.

Often

Sometimes

Rarely

Never

Clear selection

25.) I experience school-related stress.

Often

Sometimes

Rarely

Never

Clear selection

26.) I feel shy around the opposite sex.

Often

Sometimes

Rarely

Never

Clear selection

27.) I get discouraged easily.

Often

Sometimes

Rarely

Never

Clear selection

28.) I don't feel like eating and/or my weight is a big issue with me.

Often

Sometimes

Rarely

Never

Clear selection

29.) I feel confused about career decisions.

Often

Sometimes

Rarely

Never

Clear selection

30.) I feel like I am falling apart or falling to pieces.

Often

Sometimes

Rarely

Never

Clear selection

31.) I am familiar with the different types of financial aid that are available.

Often

Sometimes

Rarely

Never

Clear selection

32.) I have a problem with recreational drug use.

Often

Sometimes

Rarely

Never

Clear selection

33.) I often blame myself.

Often

Sometimes

Rarely

Never

Clear selection

34.) I fall asleep easily and get a good night's sleep.

Often

Sometimes

Rarely

Never

Clear selection

35.) I feel that everything is alright and nothing bad will happen.

Often

Sometimes

Rarely

Never

Clear selection

36.) I have family members with alcohol consumption problems.

Often

Sometimes

Rarely

Never

Clear selection

37.) I have successful personal relationships.

Often

Sometimes

Rarely

Never

Clear selection

38.) My family supports my academic endeavors.

Often

Sometimes

Rarely

Never

Clear selection

39.) I feel depressed and dejected.

Often

Sometimes

Rarely

Never

Clear selection

40.) I am comfortable with my appearance.

Often

Sometimes

Rarely

Never

Clear selection

41.) I worry about money and bills and all the time.

Often

Sometimes

Rarely

Never

Clear selection

42.) I am bothered by headaches, neck, and /or back pains.

Often

Sometimes

Rarely

Never

Clear selection

43.) I have family problems that are dragging me down.

Often

Sometimes

Rarely

Never

Clear selection

44.) I feel out of touch with my surroundings.

Often

Sometimes

Rarely

Never

Clear selection

45.) My friends support my academic endeavors.

Often

Sometimes

Rarely

Never

Clear selection

46.) I have family members with recreational drug use problems.

Often

Sometimes

Rarely

Never

Clear selection

47.) I feel more anxious and nervous than usual.

Often

Sometimes

Rarely

Never

Clear selection

48.) I have a problem with alcohol consumption.

Often

Sometimes

Rarely

Never

Clear selection

49.) I live by a "whatever " attitude.

Often

Sometimes

Rarely

Never

Clear selection

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