Name:

Block:

Student Interest Survey

Please complete the following questions so that I can better understand you as a
person and student! All this information will be kept confidential between you and me.
1. My favorite school subject is ________________________________.
2. My least favorite school subject is ____________________________.
3. Some of my hobbies include:
____________________________________________________________
____________________________________________________________
____________________________________________________________
4. Three things I would like to accomplish in my lifetime:
_____________________________________________
_____________________________________________
_____________________________________________
5. How much do you read in your free time? (Check one)
__ Daily

__ Often

__ Sometimes __ Rarely/Never

6. What types of things/genres do you read? (Check all that apply)

__ novels
__ short stories
__ newspapers
__ magazines

__ poetry

__ biographies

__ plays

__ fantasy

__ science fiction

__ mysteries __ history

__ war stories/military
__ nature

__ comics __ non-fiction __ fiction

__ adventure

__ cookbooks

__ humor

__ sports

__ folktales __ art

__ supernatural stories

__ travel

__ cars
__ romance

7. What are some of your favorite book titles/authors?

______________________________________________________________________
______________________________________________________________________
8. Do you prefer to work in groups or alone?
__________________________________________________
9. Describe your ideal (yet realistic) classroom:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
10. Describe a teacher you have liked in your past (and why you liked them):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
11. Describe a teacher you have disliked in your past (and why you disliked them):
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
12. Do you belong to any organizations, teams, or clubs in and out of school? Which
ones?
Name of club/team
Coach/Organizer
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

13. Do you have a part-time job? If so, what is it and how many hours do you work per
week? What do you like most about your job?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
14. Do you have access to a computer at home? What about internet?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
15. Is there anything else you want me to know about you?