Name
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First Name
Last Name
Email
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Date
MM
DD
YYYY
Current Grade Level:
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Middle School
9th Grade
10th Grade
11th Grade
12th Grade
College Student
Adult Student
Name of School
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For each statement below, choose the option that best represents your learning and study techniques.
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(Strongly Disagree) - I don't know where to start - 1 (Disagree) - I have not started, but I know what I need to do next - 2 (Neutral) - I am in the process of - 3 (Agree) - I have completed this, but I am not satisfied with the results - 4 (Strongly Agree) - I have completed this, and I am confident with the results - 5)
I am a quick learner but I often forget information soon after studying it.
I find it difficult to retain information for long.
I struggle to remember what I study for exams.
I want practical and effective strategies to help me balance my responsibilities and retain information better.
Describe the level of personal accountability you would have if were in the following scenario: you don't understand the content in class because of the teacher's teaching style.
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How frequently do you turn assignments in late?
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Frequently
Occasionally
Rarely
Never
How frequently do you take initiative to ask questions or go to tutoring if I have difficulty?
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Frequently
Occasionally
Rarely
Never
How frequently do you participate in class?
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Frequently
Occasionally
Rarely
Never
Rate your learning success readiness on a scale of 1-5 (5 being the best).
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(Strongly Disagree) - 1, (Disagree) - 2, (Neutral) - 3, (Agree) - 4, (Strongly Agree) - 5
A. Study Skills - My study skills are excellent, as evidenced by my grades.
B. Organizational Skills - My organizational skills are excellent, as evidenced by the effective management of my schedule and to-do lists.
C. Test-Taking Skills - My test-taking skills are excellent, as evidenced by high test scores.
D. Professional Communication - My Professional communication skills are excellent, as evidenced by my ability to connect with my teachers and peers.
E. Ability to have a positive, professional relationship with teachers - I have an ability to have a positive, professional relationship with teachers as evidenced by my consistent communication, willingness to listen and collaborate, and respectful attitude towards their expertise and experience.
F. Problem Solving - My problem-solving skills are excellent, as evidenced by my ability to understand tricky situations, think up new and clever ideas, and make things work well so we can see good results.
G. Ability to balance academics with extracurricular activities - My ability to balance academics with extracurricular activities is high, as evidenced by my ability to maintain a high GPA while actively participating in sports, clubs, and volunteer work, demonstrating time management and prioritization skills.
H. Money Management - My money management skills are excellent, as evidenced by my ability to create an adequate budget, pay bills, manage a bank account, and add to savings.
I. Home management - My home management skills are excellent, as evidenced by my ability to adequately do laundry, cook food, wash dishes, and maintain a clean living area.
J. Self Management - My self-management skills are excellent, as evidenced by my ability to effectively manage my time, prioritize tasks, get appropriate amount of sleep, and maintain focus and motivation, resulting in consistent academic and personal growth.
or try a prompt below!
