Class: _____________________

Date: ___________

Student Survey
Circle the number of how strongly you agree or disagree with the statement.
Strongly Disagree
1

Strongly Agree
3

10

1. I like it when I am provided with choices over what or how to learn.

1

10

2. I believe that school is teaching me the things that will help me be successful as
an adult.
1

10

3. In school, we discuss and learn about topics that are of interest to me.
1

10

4. I have the skills to be successful in activities and assignments in my classes.

1

10

10

5. School has helped me to understand the world that I live in.

1

6. I have some choice over what or how I can learn in some classes.
1

10

7. I feel good when I am able to complete an assignment successfully.

1

10

8. Things I learn about at school help me in my daily life outside of school.

1

10

10

9. Teachers help me on difficult or confusing assignments.

1

10. There is at least one class where we discuss or learn about things that are related
to my life outside of school.
1

10

11. The skills that I learn in school will help me in doing what I want to do after I
graduate.
1

10

Please answer the following questions as best as you can:

What was one time that you were given some choice over how to do an
activity/assignment or the choice of topic for an activity/assignment? Did this make you
more or less interested in the activity/assignment? In what way?

What was one thing that you learned about in school that was about something that was
related to your life outside of school? Did this make you more or less interested in the
activity/topic/assignment? In what way?

What is one skill that you have learned at school that has helped you to be a successful
student (get good grades, complete assignments, know how to study/read/write, know
how to do research, etc.)? How did you learn it? How did this help you in school?

What is one thing you would change about how teachers run your classes or how they
teach? Why?