Student Questionnaire – Class Name – Date
Name_______________________Cell / phone_____________________ Email_______________________________ Major____________________________
1. What classes, in addition to Name of Class, are you taking this quarter?
2. Do you have access to a computer?
3. Are you working this quarter? ___If so, what kind of work and how many hours per week?
4. Please describe some of your interests, academic or otherwise (sports, music, art).
5. What college-level English courses have you taken at Your College and elsewhere?
6. Do you speak any languages besides English?_____If so, which one(s)?___________________What language do you speak at home?______________________If you learned English, how old were you when you learned it?____________________
7. Do you like to read? Why or why not? What was the last book you read?
8. Do you like to write? Why or why not? What would you especially like to work on in your writing?
9. Have you ever received tutoring or been referred to a tutor? For what class? When?
10. Is there anything else that might affect your ability to perform in this class? (ADD, need glasses, etc.)
11. What questions or concerns do you have about this course?