Academic Discovery Questionnaire

During the academic portion of the program at SOAR each student will have opportunities for individual instruction. Our non-traditional approach is individualized based on each student needs. At the end of the session we will provide a written evaluation of your child’s progress. We do not issue grades for this summer program.

Please answer the following questions to help us better understand of your child’s academic goals. Students will receive instruction in study skills along with Math or Language Arts.
Student Name: ______Primary Subject Area: Math or Language Arts

What work would you like to see happen in that primary subject area:

______

Please list strategies or accommodations which help create an effective learning environment for your child:______

Will your child be bringing specific materials?
 No or Yes (If yes please list the materials) ______

STUDY SKILLS

Please rate 1, 2, 3, 4:1 = area of strength 4 = area of challenge

_____ Motivated to work academically _____ Ability to complete work on time

_____ Intrinsically (internally) motivated _____ Ability to set goals

_____ Extrinsically (externally) motivated _____ Ability to attain stated goals

_____ Sustained interest/motivation _____ Short term memory

_____ Ability to focus _____ Long term memory

_____ Ability to assess environment for distractions _____ Preparing for test

_____ Ability to create good learning environment _____ Note-taking

_____ Organization skills, general _____ Outlining

_____ Keeping a notebook _____ Highlighting

_____ Organizing desk, locker _____ Test-taking

_____ Time management skills, general _____ Checking completed work

_____ Using a schedule _____ Using a word processor

GENERAL

Would you describe your child as a: Would you describe your child as

Visual learner?___ yes___ no Oral expressive?___ yes___ no

Auditory learner? ___ yes___ no Written expressive?___ yes___ no

Kinesthetic learner?___ yes___ no

Tactile learning?___ yes___ no

Individual learner?___ yes___ no

Group learner?___ yes___ no

Please return this questionnaire with all other student forms.