Student Information and Interest Survey

1. Full name:__________________________________________
2. Name you prefer (if different from above): ____________________
3. When is your birthday? ______________________________________
4. Where were you born? (city and state)
_______________________________________________________
5. What is your address?
_______________________________________________________
6. List your favorite:
Color TV show

Food Movie

Soda Music group/singer

Fruit Restaurant

Candy Snack

Bible verse Dessert

Holiday Animal

Sport Subject in school

Season of the year Hobby/activity

Joy in the Journey

7. Books and Literature
Check off all of the following genre (types) of books that you would like to read.
_____ animal stories _____ adventure _____classics
_____ science fiction _____ fantasy _____ news stories
_____ horror _____ sports stories _____ history stories
_____ suspense _____ fairy tales _____ true-life stories
_____ poetry _____ mythology _____ mystery
_____ stories about children _____ comics _____ fables
8. What is your favorite book?
_______________________________________________________
9. List four books that you have read in school:
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
10. Who is your favorite author?
_______________________________________________________
11. Give a title of a book you would like to read:
_______________________________________________________
12. One classroom job you’d love to have is: ____________________________
13. List three topics you’d like to learn about/discuss this year:
_______________________________________________________
_______________________________________________________
_______________________________________________________
14. Anything else you think I should know:
_______________________________________________________
_______________________________________________________
_______________________________________________________

Joy in the Journey