Science Student History Survey - 2011-2012
Name: 


A red asterisk (*) indicates required questions.

  1. First & Last Name*


  1. I like learning about science.*
     
      1 2 3  
    yes  no


  1. Explain your aswer for #2.*


  1. What school did you go to?*
    Black Hawk
    Hall
    Reskin
    Winnebago
    Other


  1. Who was your 5th grade science teacher?*


  1. What sciences did you learn about in grade school? Check all boxes that include at least 1 subject you learned.*
    the human body
    space, planets, stars
    weather
    rocks, oceans, and/or landforms
    plants
    animals
    the environment
    sound, electricity, light, magnetism
    motion and forces
    computers and machines


  1. What sorts of experiments or science activities do you remember having done?*


  1. Do you like working in groups? Why? (check all that apply)
    yes, i can copy answers.
    yes, i get help when I get stuck.
    yes, i like to work out ideas with others.
    no, I hate to deal with others.
    no, they always copy off of me.
    no, I get into trouble with others.


  1. Do you like working alone? *
    Yes
    No


  1. What science tools have you used in the past? (i.e-magnifying glass, stop watches, eye droppers, etc.)*


  1. Do you have internet access at home?*
    Yes
    No


  1. How often do you use the internet & where do you use it?*
    never
    once a week
    2-3 times a week
    every day
    at home
    at school
    at friends' home
    at the library


  1. I'm good at math.*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. Check the following answers that you can agree with.*
    I like sudoku or other number games.
    I like computer math games.
    Often, I can't remember how to do things I learned last year.
    I get frustrated often.
    I know my times tables well.
    I'm ok with word problems.
    I'm ok with shapes.
    I'm ok at reading tables, charts, and graphs.
    I know the metric system: meters, grams, liters.
    I only do math in school.


  1. I like to read*
    Yes
    No


  1. What sorts of books do you like to read?*
    fantasy, science fiction
    horor, suspense, mystery
    funny, humor
    movie novels
    sports
    history or non-fiction/facts books
    graphic novels
    easy books
    Books that challenge my vocabulary.
    books with lots of pictures


  1. I like to draw.*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I learn well... (check all that apply)*
    reading
    watching (videos, demonstrations, etc.)
    doing activities
    writing
    drawing
    talking stuff through with classmates
    studying for quizzes
    doing projects: posters, presentations, etc.
    doing worksheets


  1. If I don't know something, I'm ok asking in class or I go ask the teacher for help later.*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I can speak a language other than English.*
    Yes
    No


  1. Does your family speak any other languages at home?*


  1. What is Learning?*


  1. How do you know if you are learning?*





Mr. Torgerson
Teacher
Marquardt Middle School
Glendale Heights, IL