Your Name:
Your E-Mail:
Your URL:
1) Are you male or female?
Male
Female
2) How old are you now?
5 yrs. old
6 yrs. old
7 yrs. old
8 yrs. old
9 yrs. old
10 yrs. old
11 yrs. old
12 yrs. old
13 yrs. old
14 yrs. old
15 yrs. old
16 yrs. old
17 yrs. old
18 yrs. old
3) What kind of school do you attend?
Public School
Parochial School
Private School
Montessori
Homeschool
4) What grade are you in now?
kindergarten
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th. grade
7th. grade
8th. grade
9th. grade
10th. grade
11th. grade
12th. grade
5) How long have you been public schooled?
never
0 yrs.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 yrs.
10 yrs.
11 yrs.
12 yrs.
13 yrs.
6) How long have you been in Parochial School?
never
0 yrs.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 yrs.
10 yrs.
11 yrs.
12 yrs.
13 yrs.
7) How long have you been private schooled?
never
0 yrs.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 yrs.
10 yrs.
11 yrs.
12 yrs.
13 yrs.
8) How long have you been in a Montessori school?
never
0 yrs.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 yrs.
10 yrs.
11 yrs.
12 yrs.
13 yrs.
9) How long have you been homeschooled?
never
0 yrs.
1 yr.
2 yrs.
3 yrs.
4 yrs.
5 yrs.
6 yrs.
7 yrs.
8 yrs.
9 yrs.
10 yrs.
11 yrs.
12 yrs.
13 yrs.
10) What grade were you in when you started public school?
NA
kindergarten
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th. grade
7th. grade
8th. grade
9th. grade
10th. grade
11th. grade
12th. grade
11) What grade were you in when you started Parochial School?
NA
kindergarten
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th. grade
7th. grade
8th. grade
9th. grade
10th. grade
11th. grade
12th. grade
12) What grade were you in when you started private school?
NA
kindergarten
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th. grade
7th. grade
8th. grade
9th. grade
10th. grade
11th. grade
12th. grade
13) What grade were you in when you started Montessori?
NA
kindergarten
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th. grade
7th. grade
8th. grade
9th. grade
10th. grade
11th. grade
12th. grade
14) What grade were you in when you started homeschooling?
NA
kindergarten
1st. grade
2nd. grade
3rd. grade
4th. grade
5th. grade
6th. grade
7th. grade
8th. grade
9th. grade
10th. grade
11th. grade
12th. grade
15) Who is the smartest person you know?
16) What is your favorite subject?
17) What is your least favorite subject?
18) What do you like to do the most?
19) Do other kids tease you or call you bad names? Explain
20) Do you have enough friends? Explain
21) Do you prefer to play with older kids, younger kids, or kids who
are the same age as you? Explain
22) What do you think about kids who join gangs? Explain
23) Is it important to have clothes that are in style? Explain
24) Do you care what others think of you? Explain
25) Do you feel you have enough play time? Explain
26) What do you and your friends talk about? Explain
27) What do you and your friends do when you are together? Explain
28) What makes learning fun? Explain
29) What would you do if you could change the world? Explain
30) What makes you happy? Explain
31) What makes you sad? Explain
32) What makes you angry? Explain
33) What's the first thing you want to do after school? Explain
34) What do you do with your free time when you are alone? Explain
35) How many times in the past year have you gotten in trouble? Explain
36) Name the most recent time you were someplace without your mom/dad knowing? Explain
37) How many books do you read in a month on your own? Explain
38) Do you have enough material things? Explain
39) What age should someone be allowed to date? Explain
40) Do you have a girlfriend/boyfriend? Explain
41) Who in your opinion is a real hero? Explain
42) If you could change yourself, what would you change? Explain
43) Do you enjoy playing with your brothers or sisters? Explain
44) Do you bite your nails, fiddle with your hair or chew your pencils? Explain
45) When you have a problem who do you go to for advice? Explain
46) What do you think life will be like in the future? Explain
47) Who is smarter?
Public Schooled Kids
Parochial Schooled Kids
Private Schooled Kids
Montessori Schooled Kids
Homeschooled Kids
Don't Know
Neither
48) Do you feel smart? Explain
49) How are your grades in school? Explain
50) Do your parents give you too many chores to do? Explain
51) Are you embarrassed to be seen with your parents when your friends are around? Explain
52) Do your parents understand you? Explain
53) Do your parents always know what is best for you? Explain
54) Are your parents ever wrong? Explain
55) Do you feel loved by your family? Explain
56) Were you ever diagnosed with a disorder such as:
ADD
ADHD
OCD
ODD
Bipolar
Tourettes Syndrome
Gifted with ADD/ADHD
Other
None
57) If you were diagnosed with a disorder, what age were you when
you were diagnosed? Explain
58) Is anyone in your family diagnosed with a disorder? Explain
59) How many kids do you know who are diagnosed with a disorder? Explain
60) What do you like most and least about school? Explain