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Sound Learning New Student Survey
Sound Learning continually looks for ways to best meet the needs of students. There are many factors that affect student success in weekly group learning situations. So that we may better serve your student, please complete this survey for each new student . Your answers are confidential and will be shared only with your student’s teachers.
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* Indicates required question
Student's Name
*
Your answer
Your student rushes through work just to get it done.
*
Always
Usually
Sometimes
Never
Your student can easily follow oral directions.
*
Always
Usually
Sometimes
Never
Your student can easily complete multi-step directions.
*
Always
Usually
Sometimes
Never
Your student procrastinates or avoids doing school because they don’t know how to get started.
*
Always
Usually
Sometimes
Never
Your student procrastinates or avoids doing school because it seems tedious, boring, or unimportant.
*
Always
Usually
Sometimes
Never
Your student procrastinates or avoids doing school because they are busy with extracurricular activities or volunteer/job responsibilities.
*
Always
Usually
Sometimes
Never
Your student has difficulty sustaining attention on school work due to internal distractions such as thinking about unrelated ideas or activities.
*
Always
Usually
Sometimes
Never
Your student has difficulty sustaining attention on school work due to external distractions such as sights, sounds, technology (phone, computer, TV, video games).
*
Always
Usually
Sometimes
Never
Your student has difficulty sustaining attention on school work because of poor quality sleep.
*
Always
Usually
Sometimes
Never
You student has difficulty realistically planning how long it will take to complete an assignment.
*
Always
Usually
Sometimes
Never
You student has difficulty with assignments that require open-ended thinking or creativity.
*
Always
Usually
Sometimes
Never
Not attempted
You student double checks their work or proofread their papers.
*
Always
Usually
Sometimes
Never
Not attempted
Your student easily loses track of assignments or important papers, either in digital or printed form.
*
Always
Usually
Sometimes
Never
Your student uses an organized, designated study area and has consistent access to a computer.
*
Always
Usually
Sometimes
Never
Your student respects authority in the home.
*
Always
Usually
Sometimes
Never
Your student respects authority outside the home.
*
Always
Usually
Sometimes
Never
Your student is comfortable participating in groups.
*
Always
Usually
Sometimes
Never
Is this the first academic classroom experience for your student? If not what other classroom experience have they had?
Your answer
List outside activities that your student regularly participates in such as debate, music, sports, Awana, and/or other activities.
*
Your answer
What are your student’s academic and/or personal strengths?
*
Your answer
Does your student struggle in any academic and/or social areas?
*
Your answer
Are there physical or mental health concerns that your student struggles with? Please explain (i.e. indicate if your student is in counseling):
*
Your answer
Please let us know if there are any special family circumstances or distractions. Indicate if your student is adopted or in foster care. Also, include family illnesses, separations, new family members, moves, etc.:
*
Your answer
Please tell us how you heard about our program.
*
Your answer
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