Survey of School Going Kids

1. Name of the Student: ________________________________________________________

2. Gender:
Male Female

3. Class:
Primary 6th to 10th 10+1 onwards

4. School Type:
Government Private

5. Education of Parents
Illiterate Up to Matriculation Graduate Post Graduate or More

6. Locality of Residence
Village Semi-Urban Urban

7. Height (in cms.):_________________________________________________________________

8. Weight (in kgs.):_________________________________________________________________
9. Academic Performance (in last class)
Subject Marks Obtained Percentage of Marks
English
Mathematics
Science
Social Studies
Hindi
Physical Education
Aggregate
10. Extra-Curricular Activities
Activity Excellent Good Average Poor
Sports (Indoor)
Sports (Outdoor)
Cultural Activities
NSS/NCC
Academic Competitions
11. Your Opinions: (1-5: Strongly Disagree Strongly Agree)
Statement
I spend too much time watching television
Junk/Fast food is a part of my meal
I like my class teacher very much.
I am encouraged to participate in cultural functions.
I have time and coaching for sports at school.
12. I want to have my career in
Sports Singing/Dancing Sciences (Doctor/Engineer) Others