Student Information Sheet
Student Information Sheet
Last Name _______________ First Name __________ Middle I. ___
Preferred Name/Nickname: __________________________________
Home Phone______________ Emergency Phone ________________
Birthday ____________ (please include year)
Parent or Guardian _________________ Relationship: ___________
Parent or Guardian _________________ Relationship: ___________
Parent or Guardian Work Phone: _____________________________
Parent or Guardian E-mail: _________________________________
Home Address ____________________________________________
City ____________ State _____ Zip Code ____________
Do you have access to Internet at home? ____________________________
Are you in the Fine Arts Program? _________________________________
What extra-curricular activities do you participate in? __________________
_____________________________________________________________
Class Schedule:
1st Block: _________________________ Room #: ____________________
2nd Block: _________________________ Room #: ___________________
3rd Block: _________________________ Room #: ____________________
4th Block: _________________________ Room #: ____________________
If you have a medical issue that I should be aware of, or if you have any other questions or concerns, please include them here: _______________________________________________________________________________________________________________________________________________________________________________________
Name: ______________________
Student Interest Survey
Five years ago … ______________________________________________.
Five years from now … _________________________________________.
I love when … ________________________________________________.
I hate when … ________________________________________________.
The farthest I have ever traveled from home is … _____________________.
My favorite place in the world is … _________________________________.
I admire __________________ because ____________________________
____________________________________________________________.
What is a good book you have read and why did you like it?_____________
_____________________________________________________________
Tell me about a good movie you’ve seen recently and why you liked it. ____
_____________________________________________________________
What is your favorite kind of music? ________________________________
What is your favorite sport? ______________________________________
What are two common activities you do when you get home? ____________
_____________________________________________________________
What wish do you have for someone else? ___________________________
_____________________________________________________________
I daydream about … ____________________________________________.
I’m curious about … ____________________________________________.
The title of a book about my life would be … _________________________.
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