1 (B) Goal Setting - Annexure-B

Annexure - B
Goal Setting Exercise

(To be filled by student on the first interaction of goal setting)
Performa for - Student
Personal Particulars:
Enrolment No.:
___________________________________________________________
Name of Student:
___________________________________________________________
School Attending/ Last Attended:
___________________________________________________________
Program Enrolled in:
___________________________________________________________
Current AY:
___________________________________________________________
Current Class:
___________________________________________________________
Section - A (Analysis)
1
How do you assess yourself as a student?

1 Class Topper
2 Excellent
3 Good
4 Average
On an average how many hours does you study ?

1 On a day you do not have School / Coaching Classes
2 On a day with School & Coaching classes
3 On a day when you have only school
4 On Examination Days
5 During Summer / Winter breaks etc
What is your preferable time of studies ?

1 Morning
2 Afternoon
3 Night
4 Anytime
Do you prefer to do different activities with proper schedule

1 Yes
2 No
5
Rate the ability of to understand new topic (Without any help)? i.e. ability to understand
through self study.
1 Excellent
2 Good
3 Average
4 Cant understand
6
Rate your ability to solve new problems (after a new chapter is taught in class)
1 Excellent
2 Good
3 Average
4 Cant solve
7
When a new problem is given to you & assuming that you were not able to solve it in first
attempt? Then what will you do
1 Try to solve it by attempting again & again
2 Try to get solution from a friend
3 Try to get solution from a senior (including parents)
4 Try to get solution from teacher
5 Leave it forever
How do you spend your free time

1 By surfing net / visiting Facebook
2 Watching TV / Playing Video Games
3 Play Outdoor Sports
4 Hang out with friends or talking on phone
5 Reading books
6 Others
Your performance during previous years has been

1 Consistent
2 Upward growth
3 Downward
4 Inconsistent
10
When a new concept is taught in the class

1 He / she is able to solve the questions based on concepts himself/herself
2 He / she takes little assistance from friends
3 He / She wait for the teacher to first sole few examples and then try
11
During regular days, how many hours do you devote for below exercise
1 Homework:
2 Revision of concepts taught in class:
3 Preparation of upcoming Unit tests or quizzes:
12
After how many Hrs of study do you need break to refresh yourself and concentrate again.
13
Which do you prefer?

1 Theory and representation based questions
2 Applications and numerical -based questions
14
Rate yourself on the following traits of success on scale of 0 to 10

1 Focus
2 Hard Work
3 Determination
4 Perseverance
5 Concentration during studies
15
Your role model is

____________________________________________________________________________________
____________________________________________________________________________________
16
Reason for selecting this person as role model :

____________________________________________________________________________________
____________________________________________________________________________________
17
Who helps you at home when you are stuck with studies ?
1 Father
2 Mother
3 Brother
4 Sister
5 Grand parents
6 Others
18
Who encourages you most in your family to achieve your goal?

1 Father
2 Mother
3 Brother
4 Sister
5 Grand parents
6 Other
19
When you encounter difficulties on the path of your life, do you

1 do nothing to remove these difficulties
2 try to remove them, at any cost, as soon as possible
3 after few unsuccessful attempts give up further attempts to remove them as it is waste of
time
20
When you study :

1 You dont care about anything else and forget the world around you
2 ask your parents and siblings to go away to prevent distraction
3 lock yourself in a room and cut out all connections
4 Does your studies but keep getting distracted very often
21
If
1
2
3
4
you get less marks in a subject:

you feel bad and move on to prepare for next exam
you dont leave any stone unturned and re do the paper to evaluate where you went wrong
You feel outrage and work hard for next exam to beat your earlier score
You hate to discuss about the paper post examinations
22
If
1
2
3
you find any difficulty in understanding a topic:

you try to solve on your own or wait for someone else to ask in the class
You make a note of it, take it home and seek help from elders who know
you ask the teacher there and then or after the class.
23
For a concept taught by the teacher do you

1 believe it to be true and accepts it as a general law or notion
2 tries to analyse and form a relation which will help you to understand it
3 establishes the relationship
24
If
1
2
3
25
When you make a schedule for study :

1 you stick to it no matter what happens
2 You change it everyday to suit the day as every day is a new day with new priorities.
3 You follow it to the best possible manner.
you get stuck in a problem you:

circle it and ask the faculty later on
review everything to get the solution and dont leave it till it is solved
call up friends/teachers for immediate help
Section B (On the basis of your strength and weakness, what goal do you set for
yourself).
Clas
s
Goal
JAO
10
10
10
10
11
11
Students
Aspiration
Admission
Test
Benchmark
State Level
National Level
For International Level
International Bronze Medal
International Silver Medal
International Gold Medal
State Level
National Level
Selection in Final Round
State Level
National Level
State Level
National Level
Selection in Final Round

Selection in Stage 1
Stage 1
Fellowship
Mentorship
JSO
JSTSE
BOARD EXAMINATIONS
Greater than 98%
Between 90% to 98%
Between 80% to 90%
Between 75% to 80%
JAO
JSO
NTSE
KVPY
OLYMPIADS-Astronomy
State Level
National Level
11
11
11
12

OLYMPIADS-Chemistry
State Level
National Level
OLYMPIADS-Physics
State Level
National Level
OLYMPIADS-Mathematics
State Level
National Level
OLYMPIADS-Astronomy
State Level
National Level
OLYMPIADS-Chemistry
State Level
National Level
OLYMPIADS-Physics
State Level
National Level
KVPY
Stage 1
Fellowship
Mentorship
12
12
12
12
OLYMPIADS-Mathematics
State Level
National Level
12
12
12
BOARD EXAMINATIONS
Greater than 98%
Between 90% to 98%
Between 80% to 90%
Between 75% to 80%
IIT-JEE Advanced
Topper
Top 10
Top 200
Top 2000
Selection at any rank
IIT-JEE Mains
Topper
Top 10
Top 200
Top 2000
Top 10000
Top 30000
Top 150000
Signature of the Student / Parent

faculty member
Date / Place
(Signature of Student)
Signature of the

1 (B) Goal Setting - Annexure-B

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Annexure - B

Goal Setting Exercise

School Attending/ Last Attended:

Program Enrolled in:

How do you assess yourself as a student?

On an average how many hours does you study ?

What is your preferable time of studies ?

Do you prefer to do different activities with proper schedule

How do you spend your free time

Your performance during previous years has been

When a new concept is taught in the class

Which do you prefer?

Rate yourself on the following traits of success on scale of 0 to 10

Your role model is

Reason for selecting this person as role model :

Who encourages you most in your family to achieve your goal?

When you encounter difficulties on the path of your life, do you

When you study :

you get less marks in a subject:

you find any difficulty in understanding a topic:

For a concept taught by the teacher do you

When you make a schedule for study :

you get stuck in a problem you:

Selection in Final Round

Selection in Final Round

International Bronze Medal

Signature of the Student / Parent

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