Welcome to Science! Please take a few minutes to tell me a little bit about yourself and

your experiences with Science in Elementary School.

1. What is your name? ________________________________________________

2. Do you have any brothers or sisters? If so, how many? _____________________

3. Have you lived here all your life? If not, where else have you lived?

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4. Do you have any pets? If so, what do you have? __________________________

5. What’s your favorite movie? (what’s the best movie you’ve seen in the last

year?) ____________________________________________________________

6. What do you like to do in your free time? _______________________________

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7. Do you play any sports? If so, which one(s)? ____________________________

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8. What is the farthest place you’ve traveled to outside of Des Moines?

______________

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9. If you had to pick your three favorite foods, what would they be?

a. _________________________

b. _________________________

c. _________________________

10. What’s your favorite restaurant? _______________________________________

11. Do you have any musical talents (i.e. play an instrument, sing, etc.)? __________

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12. If a genie granted you three wishes, what would they be?

a. ________________________________

b. ________________________________

c. ________________________________

13. What job would you like to have when you get older? ______________________

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14. On a scale of 1-10, rate how much Science you learned in middle school: 1 2 3 4 5 6 7 8 9 10

(none) (a lot each week)

15. On a scale of 1-10, rate how you feel about Science (be honest – you won’t hurt

my feelings): 1 2 3 4 5 6 7 8 9 10

(not interested) (really interested)

16. Can you list any jobs that you could have if you took enough Science in school?

a. ______________________________

b. ______________________________

c. ______________________________

d. ______________________________

17. Can you think of three things in your life that wouldn’t be there without Science?

a. ______________________________

b. ______________________________

c. ______________________________

18. What is your favorite part of science or science topic? _____________________

19. What can I do to make this class interesting and enjoyable to you?

_________________________________________________________________

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20. Is there anything else that you would like to tell me about yourself? Any hidden

talents? ___________________________________________________________

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Thanks for taking the time to answer these questions.

I look forward to getting to know you this school year!