Name: __________________

Date: ___________________
Period:__________________
Student Interest Survey
1. The three things I do best in school are:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

2. Some of the things that I would like to work on this year are:
____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

3. The grade that I want to earn in math class is __________________________

4. Outside of school, my favorite activities are:

____________________________________________________________________
____________________________________________________________________
____________________________________________________________________

5. The clubs, organizations, or private lessons I participate in are:

_____________________________ __________________________________
_____________________________ __________________________________

6. My favorite sport is: _______________________________________________.

7. My three favorite books are:

__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

8. When I grow up, I want to be a ______________________________________.

 Name: __________________
Date: ___________________
Period:__________________
8. If I could choose between watching television (or movies), playing on the
computer, or playing sports, I would choose _____________________________
because ____________________________________________________________.

9. The person whom I most admire is ___________________________ because

___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________

10. The languages that I speak are: ____________________________________

___________________________________________________________________
___________________________________________________________________.

11. Some of the chores or responsibilities that I have are: __________________

___________________________________________________________________
___________________________________________________________________.

12. Three of my friends are: ___________________________________________

___________________________________________________________________
___________________________________________________________________.

13. When I am with my friends, we like to _______________________________

___________________________________________________________________
___________________________________________________________________.

14. Something about me that I would like to share with you is ______________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________.