Name #: ______________________________________________________________ Date: _________________

5th Grade Student Questionnaire Written by: Stephanie Moorman http://teachinginroom6.blogspot.com

Directions: Read each question below. Answer truthfully on the lines. The idea is to tell me more about you so that I can make our year as interesting and meaningful as possible. Write as neatly as you can and include as much information as possible.

1. Who do you live with? _______________________________________________________________ 2. Who takes care of you? ______________________________________________________________ 3. What is the name of your: mom _______________________________ dad _________________________________ sisters _____________________________ brothers _____________________________ _____________________________ _____________________________ others in your house _____________________________________________________________ pets __________________________________________________________________________ 4. What language do you MOSTLY speak at home? __________________________________________ 5. Who were your past teachers? 1st grade _______________________________________________________________________ 2nd grade _______________________________________________________________________ 3rd grade _______________________________________________________________________ 4th grade _______________________________________________________________________ 6. What is your favorite subject? __________________________________ Why? _________________ _______________________________________________________________________________ _______________________________________________________________________________ 7. What is your LEAST favorite subject? _____________________________ Why? ________________ _______________________________________________________________________________ _______________________________________________________________________________ 8. When you have a few extra minutes to do whatever you want, what do you like to do most? Why? ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 9. Do you play any sports? __________ Which ones? ______________________________________ 10. On the weekends, what do you usually do? ______________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

11. Who is your best friend? ___________________________

Is that person in our class? _________

12. If you could invite 3 people from our class to your birthday party, who would you invite and why? _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 13. Do you consider yourself a well-behaved student? ________ What do you do that makes you either well behaved or a troublemaker? _________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ 14. Do you think of yourself as a smart student? ________ Why or why not? _____________________ _______________________________________________________________________________ _______________________________________________________________________________

Are there any questions you have for me? Anything you would like to know about me or questions about 5th grade? Write them on the lines below and I will answer them as soon as possible. _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________