NAME:

STUDENT SURVEY DATE:

PERIOD: STUDENT NUMBER:

LEARNING STYLES: Circle all answers that apply to you.

1. I work well when I:

A. Read about content/topics

B. Use hands on materials
C. Talk to others and get ideas
D. Use the computer
E. Listen and watch

2. When Im learning, I need:

A. Peace and quiet

B. Music or quiet noise
C. To be able to move around
D. To be able to talk with others

3. I prefer to work:

A. Alone
B. With one partner
C. In small groups

4. When I need help, I:

A. Raise my hand and ask the teacher immediately

B. Ask the teacher privately
C. Wait for the teacher to ask me if I need help
D. I dont like to ask for help.
Please describe why: ____________________________________

INTERESTS
5. Why did you take this class?

6. List any projects and/or skills you would like to learn in this class:

7. What are your favorite school subjects?

8. What are your extra curricular activities/interests? (School clubs, personal hobbies, sports, etc.)

5. Describe yourself in three words:9

 STUDENT SURVEY

GOALS:
10. ACCP Class Goals - Describe any learning goals you would like to achieve in this class.

11. High School Goals - What do you hope to achieve by the time you graduate high school?

12. Post Graduation/Career goals - What do you plan to do after high school?

ACADEMIC SKILLS AND GENERAL ACCOMONDATIONS NEEDED:

13. Seating: I work best when I am seated:

A. At the front of the class

B. Near speakers/presentation guides
C. Near the teachers assistant so I can ask for help

14. Please describe anything that makes learning difficult for you:

EXPERIENCE AND BACKGROUND IN ARTS AND COMMUNICATION:

15. List and describe any art and/or arts and communication classes you have taken in the past.
What did you learn? What would you like to improve on?

RATE YOURSELF ON THE FOLLOWING SKILLS/TASKS:

(Shade in the following scales to your level)
1 - Low skill level 5- High skill level

16. Hand drawing real life subjects 1 2 3 4 5

17. Choosing colors that work well together 1 2 3 4 5

18. Coming up with creative ideas 1 2 3 4 5

19. Problem solving 1 2 3 4 5

20. Overall artistic skills 1 2 3 4 5

21. Using Adobe Illustrator 1 2 3 4 5

22. Using Adobe Photoshop 1 2 3 4 5