New Student Survey
Please take a moment to provide us with some valuable information about yourself so that we can support your success at Sierra. 
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Last Name *
First Name *
Student ID  *
Email Address *
Student's Phone Number *
Grade  *
Nickame or Preferred Name *
How do you get to school (example: walk, bus) *
My responsibilities outside of school are (example: job) *
Hobbies & Interests *
My future career goal is *
My favorite subject is *
My least favorite subject is *
How often do you have difficulty with each of the following learning strategies?
0 = Never have difficulty
1 = Sometimes have difficulty
2 = Often have difficulty
 *
0
1
2
Speaking up in class
Understanding what people are saying
Hearing what people are saying
Seeing the board/screen or reading small print
Asking for help from teachers
Managing nervousness during tests
Staying on task / avoiding distractions
Working by myself
Working with others or in a group
Concentrating on schoolwork because I have a lot of things on my mind
How often does each of the following make it difficult for you to attend school regularly?
0 = Never 
1 = Sometimes
2 = Often
 *
0
1
2
Transportation problems
Health issues
Family member with health issues
Parenting responsibilities (I am a parent)
Caring for siblings or ederly family members
Other family responsibilities
Work (my job)
Other
In the past, what has helped me at school is *
What might help you if you are having a tough day at school? *
Have you experienced any bullying or conflict with any other students that could keep you from coming to school? 
If so please explain and provide specific names if you have any safety concerns. 
 *
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