Intake Questions for PERPers
PeRL Intake Form
Appointment Date:_____________ Time: _________ Reminder Call: __________
Promised by: _____________ Interviewer initials ________
Contact Information:
Full Name _____________________________________________________________
Phone ______________________ Email __________________________________________
Age _____ Grade _______ Boy / Girl (circle one)
1. What are your favorite books? (books you have loved)
2. What else have you read that you liked? (titles, authors, genres)
3. Have you read any books you hated? Do you know why you didn’t like them?
4. How often do you read? How long do you give a book before giving up on it?
5. What book are you reading now, or what was the last book you read? What did you think of it?
6. If we could find you a perfect book, what would it be about or have in it?
7. Anything else we should know that will help us recommend books you will like? What are your hobbies and interests outside of school and reading?
What kind of books do you enjoy?
| short books | realistic fiction |
|medium books |romance |
|long books |sports |
|funny books |animal (fantasy) |
|scary books |animal (realistic) |
|sad books |series books |
|adventure |books not in a series |
|survival |books with girl main characters |
|mysteries |books with boy main characters |
|fantasy |YA fiction |
|historical fiction |graphic novels |
|science fiction |nonfiction |
|classics | |
What Have They Read?
Cross out books already read and mark under + if they liked it or - if they did not. Circle books they are interested in.
+ - Contemporary Fantasy
□ □ 11 Birthdays* (Mass)
□ □ The Alchemyst* (Scott)
□ □ Artemis Fowl* (Colfer)
□ □ Bliss* (Littlewood)
□ □ Children of the Lamp* (Kerr)
□ □ Cold Cereal* (Rex)
□ □ Coraline, Graveyard Book (Gaiman)
□ □ Crenshaw (Applegate)
□ □ Doll Bones (Black)
□ □ Eighth Day* (Salerni)
□ □ Emerald Atlas* (Stephens)
□ □ Fablehaven* (Mull)
□ □ Flora & Ulysses (DiCamillo)
□ □ Harry Potter* (Rowling)
□ □ House of Secrets* (Columbus)
□ □ Land of Stories* (Colfer)
□ □ Lightning Thief*, Red Pyramid* (Riordan)
□ □ Savvy* (Law)
□ □ Series of Unfortunate Events* (Snicket)
□ □ Spiderwick* (DiTerlizzi)
□ □ Spirit Animals series
□ □ The Phantom Tollbooth (Juster)
□ □ Underland Chronicles* (Collins)
□ □ Unicorn Chronicles* (Coville)
□ □ Unwanteds* (McMann)
□ □ Wildwood* (Meloy)
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+ - Fantasy set in the Past (or something like it)
□ □ Airborn* (Oppel)
□ □ Amulet of Samarkand* (Stroud)
□ □ Eragon* (Paolini)
□ □ Goblin Secrets* (Alexander)
□ □ Golden Compass* (Pullman)
□ □ Hero’s Guide to Saving Your Kingdom* (Healy)
□ □ How to Train Your Dragon* (Cowell)
□ □ How to Catch a Bogle* (Jinks)
□ □ Inkheart,* Dragon Rider (Funke)
□ □ Jinx* (Blackwood)
□ □ Last Apprentice* (Delaney)
□ □ Lockwood & Co.* (Stroud)
□ □ Pandora gets…* (Hennesy)
□ □ Peter and the Starcatchers* (Barry)
□ □ The School for Good & Evil* (Chomani)
□ □ Sea of Trolls* (Farmer)
□ □ Septimus Heap* (Sage)
□ □ Seraphina (Hartman)
□ □ The Hobbit (Tolkien)
□ □ The Lion, the Witch and the Wardrobe*(Lewis)
□ □ The Thickety (White)
□ □ The Wee Free Men,* Nation, Dodger (Pratchett)
□ □ Wings of Fire* (Sutherland)
□ □ Wolf Brother (Paver)
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+ - Contemporary Realistic Fiction
□ □ 13-Story Treehouse* (Griffiths)
□ □ A Mango-Shaped Space (Mass)
□ □ Counting by 7s (Sloan)
□ □ Because of Mr. Terupt* (Buyea)
□ □ Better Nate than Ever* (Federle)
□ □ Diary of a Wimpy Kid*(Kinney)
□ □ Eleven*(Myracle)
□ □ Frindle, Room One (Clements)
□ □ From the Mixed-up Files... (Konigsburg)
□ □ The Great Greene Heist* (Johnson)
□ □ Holes, Sideways Stories (Sachar)
□ □ Hoot, Flush, Scat, Chomp (Hiaasen)
□ □ I Funny, Middle School... Treasure Hunters* (Patterson)
□ □ Maniac Magee, Stargirl* (Spinelli)
□ □ Mother - Daughter Book Club* (Frederick)
□ □ Out of My Mind (Draper)
□ □ Penderwicks* (Birdsall)
□ □ Rules (Lord)
□ □ The Running Dream / Flipped (Van Draanen)
□ □ The Strange Case of Origami Yoda* (Angleberger)
□ □ The Terrible Two* (Barnett)
□ □ Wonder (Palacio)
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+ - Historical Realistic Fiction
□ □ Al Capone Does My Shirts* (Choldenko)
□ □ Bud, Not Buddy (Curtis)
□ □ Chains*(Anderson)
□ □ Dead End in Norvelt* (Gantos)
□ □ Echo (Ryan)
□ □ Evolution of Calpurnia Tate* (Kelly)
□ □ I Survived...* (Tarshis)
□ □ Kira Kira (Kadohata)
□ □ Midwife's Apprentice (Cushman)
□ □ Moon Over Manifest (Vanderpool)
□ □ One Crazy Summer* (Williams-Garcia)
□ □ Paperboy (Vawter)
□ □ The Invention of Hugo Cabret, Wonderstruck, The Marvels (Selznick)
□ □ Turtle in Paradise (Holm)
□ □ War that Saved My Life (Bradley)
□ □ Wednesday Wars, Okay for Now (Schmidt)
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+ - Mystery
□ □ Brixton Brothers* (Barnett)
□ □ Candymakers (Mass)
□ □ Chasing Vermeer (Balleitt)
□ □ Enola Holmes* (Springer)
□ □ Escape from Mr. Lemoncello's Library*,
Island of Dr Libris (Grabenstein)
□ □ Greenglass House (Milford)
□ □ Hardy Boys* (Dixon)
□ □ Mysterious Benedict Society* (Stewart)
□ □ Nancy Drew* (Keene)
□ □ Pie (Weeks)
□ □ Red Blazer Girls* (Beil)
□ □ Ruby in the Smoke (Pullman)
□ □ Ruby Redfort* (Child)
□ □ Sammy Keyes* (Van Draanen)
□ □ Sisters Grimm* (Buckley)
□ □ The Fourth Stall* (Rylander)
□ □ The London Eye Mystery (Dowd)
□ □ The Westing Game (Raskin)
□ □ Three Times Lucky* (Turnage)
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+ - Adventure Fiction – Knights, Pirates etc.
□ □ Bloody Jack series* (Meyer)
□ □ Ranger's Apprentice* (Flannagan)
□ □ The False Prince* (Nielsen)
□ □ The Hero and the Crown* (McKinley)
□ □ The Thief* (Turner)
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+ - Adventure - Woods and stuff
□ □ Hatchet (Paulsen)
□ □ Island of the Blue Dolphins (O'Dell)
□ □ Julie of the Wolves* My Side of the Mountain (George)
□ □ Little House on the Prairie* (Wilder)
□ □ Shadow of the Mountain, Heart of a Samurai (Preus)
□ □ Small as an Elephant (Jacobson)
□ □ The Sign of the Beaver (Spear)
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+ - Adventure Fiction - Spies and stuff
□ □ 39 Clues series*
□ □ A Whole Nother Story* (Soup)
□ □ Alex Rider* (Horowitz)
□ □ Genius Files* (Gutman)
□ □ H.I.V.E.* (Walden)
□ □ I, Q. series* (Smith)
□ □ Kiki Strike* (Miller)
□ □ N.E.R.D.S.* (Buckley)
□ □ Masterminds* (Korman)
□ □ Spy School (Gibbs)
□ □ The Name of this Book is Secret, Bad Magic* (Bosch)
□ □ Young Bond (Higson)
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+ - Science Fiction
□ □ A Wrinkle in Time* (L'Engle)
□ □ Among the Hidden* (Haddix)
□ □ Boom! (Haddon)
□ □ City of Ember* (DuPrau)
□ □ Cosmic (Cottrell Boyce)
□ □ Ender's Game* (Card)
□ □ Fortunately The Milk (Gaiman)
□ □ The Fourteenth Goldfish (Holm)
□ □ Hitchhiker's Guide to the Galaxy* (Adams)
□ □ Mars Evacuees* (McDougall)
□ □ The Giver* (Lowry)
□ □ The Roar* (Clayton)
□ □ The Search for Wondla* (DiTerlizzi)
□ □ The True Meaning of Smekday* (Rex)
□ □ When You Reach Me (Stead)
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+ - Nonfiction
□ □ A Black Hole is Not a Hole (DiCristofano)
□ □ Abraham Lincoln & Frederick Douglass (Freedman)
□ □ Beyond Courage: The Untold Story of Jewish Resistance During the Holocaust (Rappaport)
□ □ Bomb, Most Dangerous (Sheinkin)
□ □ Courage Has No Color (Stone)
□ □ Moonbird (Hoose)
□ □ Neighborhood Sharks (Roy)
□ □ Temple Grandin (Montgomery)
□ □ The Mighty Mars Rovers (Rusch)
□ □ Who Was...?*
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+ - Realistic Animals
□ □ Because of Winn Dixie (DiCamillo)
□ □ Black Beauty (Sewell)
□ □ Cracker (Kadohata)
□ □ Ghetto Cowboy (Neri)
□ □ Misty of Chincoteague* (Henry)
□ □ One Dog and His Boy (Ibbotson)
□ □ Pax (Pennypacker)
□ □ Shiloh* (Naylor)
□ □ The Black Stallion* (Farley)
□ □ The Dog Days of Charlotte Hayes* (Kennedy)
□ □ The Underneath (Appelt)
□ □ War Horse, Kensuke's Kingdom (Morpurgo)
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+ - Fantasy Animals
□ □ A Nest for Celeste (Cole)
□ □ Fog Mound* (Schade)
□ □ Guardians of Ga'Hoole* (Lasky)
□ □ Mrs. Frisby and the Rats of NIMH* (O'Brien)
□ □ Nuts to You (Perkins)
□ □ Redwall* (Jacques)
□ □ Secrets at Sea (Peck)
□ □ Silverwing* (Oppel)
□ □ The Familiars* (Epstein)
□ □ The One and Only Ivan (Applegate)
□ □ The Tale of Despereaux (DiCamillo)
□ □ True Blue Scouts of Sugarman Swamp (Appelt)
□ □ Warriors* (Hunter)
□ □ Watership Down (Adams)
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+ - Graphic Novels
□ □ Dumbest Idea Ever (Gownley)
□ □ Amulet (Kibuishi)
□ □ Babysitters' Club (Telgemeier)
□ □ Bone (Smith)
□ □ El Deafo (Bell)
□ □ Princeless* (Whitley)
□ □ Roller Girl (Jamieson)
□ □ Smile, Sisters, Drama (Telgemeier)
□ □ Tintin (Herge)
□ □ Zita the Space Girl (Hatke)
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+ - Sports
□ □ Airball: My Life in Briefs (Harkraker)
□ □ All the Broken Pieces (Burg)
□ □ Babe and Me* (Gutman)
□ □ Best of the Best (Green)
□ □ Heat (Lupica)
□ □ Hothead* (Ripkin)
□ □ Last Shot... A Final Four Mystery* (Feinstein)
□ □ Southpaw (Wallace)
□ □ The Aurora County All-Stars (Wiles)
□ □ The Crossover (Alexander)
□ □ The Girl Who Threw Butterflies (Cochrane)
□ □ _____________________________________
□ □ _____________________________________
+ - YA
□ □ City of Bones* (Clare)
□ □ Divergent* (Roth)
□ □ Feed,* Octavian Nothing (Anderson)
□ □ Graceling* (Cashore)
□ □ House of the Scorpion* (Farmer)
□ □ Hunger Games* (Collins)
□ □ I am Number Four (Lore)
□ □ Incarceron* (Fisher)
□ □ Legend* (Lu)
□ □ Leviathan series* (Westerfield)
□ □ Little Brother (Doctorow)
□ □ Matched* (Condie)
□ □ Maximum Ride* (Patterson)
□ □ Ship Breaker* (Bacigalupi)
□ □ Shiver (Stiefvater)
□ □ Sisterhood of the Traveling Pants* (Brashares)
□ □ Speak (Anderson)
□ □ Tangerine (Bloor)
□ □ The Book Thief (Zusak)
□ □ The Fault in Our Stars (Green)
□ □ The Maze Runner* (Dashner)
□ □ The Recruit* (Muchamore)
□ □ The Selection* (Cass)
□ □ Trash (Mulligan)
□ □ ttyl* (Myracle)
□ □ Twilight* (Meyer)
□ □ Uglies* (Westerfield)
□ □ _____________________________________
□ □ _____________________________________
Now that we've talked about all these books, are there any other books that you remember reading?
□ □ _____________________________________
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□ □ _____________________________________
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List what they took home today:
□ □ _____________________________________
□ □ _____________________________________
List any books or authors they haven't read that you think they might be interested in:
□ □ _____________________________________
□ □ _____________________________________
Interviewer Summary:
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