1. Are you currently reading a book for pleasure? (Circle one) YES NO Title: _____________________________________________________________________ 2. What words pop into your mind when you think of reading a book? ___________________ __________________________________________________________________________ 3. Do you read at home? (Circle one) YES NO 4. Do you ever read a book for pleasure? (Circle one) YES NO 5. When I read for pleasure, I pick the following: Circle all that apply. Novels/chapter books History books Picture books Newspapers Sports books Mystery books Poetry books Fantasy books Fiction books Cartoons/comic books Science books Biographies Humorous books Scary books Non-fiction books Magazines Poetry books Other _______________________ 6. I am more likely to read a book for pleasure that: (Circle all that apply) a teacher suggests my friend suggests a librarian suggests has won a medal is by an author whose I just happened to see/hear books I have read about in _______________
7. My favorite book ever was ____________________________________________
8. My favorite author is _________________________________________________ 9. My favorite magazine is _______________________________________________ 10.In the past month I have read _________books for pleasure. 11.I have a public library card. (Circle one) YES NO 12.How often do you borrow books from the public library? _________________________ 13.How often do you borrow books from the school library? _________________________ 14.The number of books I have at home: Circle one None 0-9 10-19 20-29 30-50 More than 50 15.I own a Kindle, Nook, or another e-reader. (Circle one) 16.What gives you the most problems when you read?
_________________________________________ __________________________________________________________________________ 18.I would like to read a book about _______________________________________________ ___________________________________________________________________________ 19.I read best when _____________________________________________________________ ____________________________________________________________________________ 20.I believe reading is important because _____________________________________________ _____________________________________________________________________________