Back to School Survey
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Name: 


A red asterisk (*) indicates required questions.

  1. How strongly do you agree with the following statement?
    "I will participate in class discussions"*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How strongly do you agree with the following statement?
    "I will be successful in social studies this year."*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How strongly do you agree with the following statement?
    "I will ask for help if I don't understand something."*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How strongly do you agree with the following statement?
    "I enjoy watching videos to reinforce what I am learning in class."*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How strongly do you agree with the following statement?
    I enjoy playing games to review content I have learned in class.*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How strongly do you agree with the following statement?
    "I will submit my assignments on time."*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How much time do you typically spend on homework each night?*
    0-20 minutes
    20-40 minutes
    40- 60 minutes
    More than 1 hour


  1. How strongly do you agree with the following statement?
    "Tests stress me out."*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. How strongly do you agree with the following statement?
    "I enjoy coming to school."*
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. Write one word that describes you as a person.*


  1. Write down one word you would use to describe how you feel about Social Studies class.*


  1. What subjects do you enjoy studying the most?*


  1. What are your favorite things to do when you're not in school?*


  1. What kind of job/career interests you? *


  1. How strongly do you agree with the following statement?
    "I am confident about learning remotely."
      1 2 3 4 5  
    Strongly agree   Strongly disagree





Mrs. Robinson
C.J. Hooker Middle School
Goshen, NY