Get To Know You Survey

Student Survey/Information Sheet Name: ______________________________

Birthday: ____________________

Address: _____________________________

Home Phone number: ______________

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Cell number:

Email Address:

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Mom’s Name:

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Dad’s Name: ___________________________ Do you have any siblings (brothers or sisters?) Yes

______________

No

Interesting Facts about Me Do you have any siblings (brothers or sisters?) List their names and ages.

yes

no

Name ___________________________

Age ____

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Do you have any pets?

yes

no

Type of Animal

Name

_______________

________________

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________________

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________________

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Favorite… Color: _____________________________________________________________ Singer/ Musical Artist: ________________________________________________ Movie: ____________________________________________________________ Book/ Genre/ Magazine: _______________________________________________ Game: _____________________________________________________________ Hobby: ____________________________________________________________ Food: _____________________________________________________________ Candy: ____________________________________________________________ TV Show: __________________________________________________________ Actor/ Actress: _____________________________________________________ Athlete: ___________________________________________________________ School Subject: _____________________________________________________ Sport: ____________________________________________________________ Flavor of ice cream: __________________________________________________ Thing to do in your free time: ___________________________________________ __________________________________________________________________ Tell me three things you are good at: ______________________________________ __________________________________________________________________ If I had one wish, it would be… __________________________________________ __________________________________________________________________ If I had a million dollars, I would… _______________________________________

__________________________________________________________________ After I graduate, I want to… ___________________________________________ __________________________________________________________________ Tell me what one of your teachers did last year that you liked: ___________________ __________________________________________________________________ Who is your hero? ___________________________________________________ Draw what you think would be the “perfect” day for you.

Something you want to know about Mrs. Howard or Mrs. Heider is: Teacher: (circle one)

Mrs. Howard

Mrs. Heider

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