JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Classroom Survey
Please answer the following questions so that I can learn more about your life outside of this class. Your responses will help me create a classroom space where you can thrive as a learner this year.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
How do you get to/from school? (check all that apply)
*
someone I know drives me
I drive myself
public transportation (bus, train, etc.)
walk, bike, skateboard, scooter, etc.
Other:
Required
How long does it take you to get to and from school every day? (check all that apply)
*
less than 15 min each way
15-30 min each way
30 min - 1 hour each way
more than 1 hr each way
it's unpredictable (traffic, delays with public transport, my ride is late, etc.)
Other:
Required
What responsibilities do you have after school and on weekends? (check all that apply)
*
caring for others (babysitting, helping a grandparent or neighbor, etc.)
job
household chores
volunteer work / community service
extra curricular activities (sports, clubs, instrument, etc.)
homework
appointments (doctor visits, therapy, counseling, tutoring, etc.)
Other:
Required
How much time per week do you spend on these other responsibilities? (just an estimate)
*
Choose
fewer than 5 hours per week
5-10 hours per week
10-20 hours per week
more than 20 hours per week
When you are not in school, do you have access to the following? (check all that apply)
*
computer
tablet
phone
internet (to visit school websites, stream video, download and upload assignments)
clean, cleared off desk/table and chair
quiet space
books of interest at your reading level
magazines, journals, newspapers
a trusted and available adult
art supplies (scissors, glue, tape, different types of paper, markers, pencils, etc.)
Required
How often do you have access to the items you selected above?
*
every day
1-2 days per week
3-5 days per week
a few days every couple of weeks
it's unpredictable (always changing, not reliable, I have to share with others)
Do you have the ability to easily get to local museums, libraries, theaters, etc.? (less than 30 min travel time each way)
*
Yes
No
Sometimes
During last school year, if you were to do all the homework you were assigned every day, how long would it take you each day?
*
less than one hour a day
1-2 hours a day
2-3 hours a day
more than 4 hours a day
Did you find it challenging to complete assigned homework and prepare for assessments?
*
Yes
No
Sometimes
What, if anything, makes completing homework/studying outside of school challenging for you?
Your answer
Describe a homework assignment, project, or assessment you studied for outside of school that you learned a lot from.
Your answer
What do you want your teacher to know about you?
Your answer
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
