Student Information Survey
Name: 


  1. What class period do you have Mrs. Hill's class?
    1st period
    2nd period
    3rd period
    4th period
    5th period
    6th period
    7th period


  1. What is the name you want me to call you?


  1. Grade:
    9
    10
    11
    12


  1. Address:


  1. Home phone number:


  1. How many siblings do you have?


  1. Brothers (ages):


  1. Sisters (ages):


  1. What kind of pets do you have?


  1. What extracurricular activities are you involved in ?


  1. What are your hobbies?


  1. What sports are you interested in?


  1. Do you have any health problems that I need to be aware of?


  1. If you are currently employed, tell me where:


  1. Where have you worked before?


  1. What are your career plans for the future?


  1. Please tell me your mother's name, daytime phone number and email address.


  1. Please tell me your father's name, daytime phone number and email address.


  1. Please tell me your guardian's name, daytime phone number and email address.


  1. Please tell me your other guardian's name, daytime phone number and email address.


  1. Who do you live with?


  1. Which parent or guardian would you like me to contact if I need to call home?



  1. Please tell me what you expect from this class.


  1. Please tell me anything else you wish for me to know about you.





Mrs. Hill