Student Input Form
My name is: *
My birthday is: *
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My age is: *
My current grade is: *
I feel like the easiest subject for me is: *
I feel like the hardest subject for me is: *
It helps me when I:
Column 1
have things read aloud to me
sit away from other students
have extra time
sit away from the other students
sit right beside the teacher
have multiple choice spelling test
have directions read aloud
have key words highlighted
have help reading words I don't know
have math visuals
I have a hard time:
Column 1
reading words by myself
making friends
doing math work
spelling
finishing my work
paying attention
following directions
writing neatly
seeing the board
hearing the teacher
organizing my desk
remembering to do my homework
keeping up with my materials
At home, I like to: *
When I grow up I want to be a: *
Do you like school?  (Be honest) *
Why or Why not?  If there is something you could change about school, what would it be? *
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