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WELCOME IN

Directions: Answer the following questions to the best of your ability. The answers will be between you and your instructor. If you feel that any question should be omitted, write No Comment in the blank.
A. IDENTIFICATION
1. NAME______________________________ AGE_____GRADE______

2. ADDRESS______________________________ PHONE____________

3. FATHERS OCCUPATION ___________________________________

4. MOTHERS OCCUPATION __________________________________

5. NUMBER OF BROTHERS ___________________________________

6. NUMBER OF SISTERS ______________________________________

7. POSITION IN THE FAMILY (OLDEST, 1ST, 2ND, ETC.) ___________

8. EMPLOYER, IF WORKING __________________________________
B. PHYSICAL HEALTH
1. HEIGHT _____________

2. SERIOUS ILLNESSES I HAVE HAD ____________________________

3. EYESIGHT (UNDERLINE ONE) EXCELLENT, GOOD, GOOD WITH GLASSES, OR CONTACTS, AVERAGE, BELOW AVERAGE

4. ANY PHYSICAL HANDICAPS THAT WOULD EFFECT JOB ________
C. SCHOOL
1. SUBJECTS I LIKE MOST_________________________________________

2. SUBJECTS I LIKE LEAST ________________________________________

3. SCHOOL ACTIVITIES I PARTICIPATE IN _________________________

4. HOURS PER WEEK I STUDY ____________________________________

5. MY STUDY SKILLS ARE ______________________________________

6. MY ABILITY IS ________________________________________________

7. I AM ACHIEVING ______________________________________________

8. MY FAVORITE GRADE IN SCHOOL WAS _________________________

D. THE PAST
1. MY HAPPINESS IN THE PAST HAS BEEN (UNDERLINE ONE)
WELL ABOVE AVERAGE, ABOVE AVERAGE, AVERAGE, BELOW AVERAGE

2. IN THE PAST, I TRIED TO BE MOST LIKE _________________________

3. THE EARLIEST THING I REMEMBER FROM THE PAST IS __________
_________________________________________________________________

4. MY HAPPIEST MEMORY IS _____________________________________

_______________________________________________________________

5. MY UNHAPPIEST MEMORY IS __________________________________

_______________________________________________________________

E. THE FUTURE
1. IN THE FUTURE I WANT TO BE (CIRCLE ONE) MARRIED, SINGLE

2. IN THE FUTURE I WANT ___________ NUMBER OF CHILDREN

3. AFTER GRADUATION, I WANT TO:

A. GO TO COLLEGE FULL TIME
B. WORK AND GO TO COLLEGE
C. WORK
D. GO TO TRADE SCHOOL
E. OTHER- _______________________________________________

4. I HOPE MY FUTURE OCCUPATION WILL BE_____________________
5. IN THE FUTURE, I HOPE TO (UNDERLINE ONE) BE ABOUT THE SAME, CHANGE A LITTLE, CHANGE A BIT, CHANGE

6. MY PLANS FOR THE FUTURE ARE ______________________________

7. IN THE FUTURE I WOULD LIKE TO BE LIKE ______________________



F. SENTENCE COMPLETION

COMPLETE THE FOLLOWING SENTENCE PARTS. WRITE THE FIRST THING YOU THINK OF

1. MY BROTHER __________________________________________________

2. MY SISTER _____________________________________________________

3. MY TEACHERS ________________________________________________

4. MY MOTHER__________________________________________________

5. MY FATHER___________________________________________________

6. BOYS ARE ____________________________________________________

7. MEN ARE _____________________________________________________

8. GIRLS ARE ____________________________________________________

9. WOMEN ARE __________________________________________________

10. MY HOME IS __________________________________________________

11. SCHOOL IS ____________________________________________________

12. I WANT _______________________________________________________

13. MY MAIN ASSET IS ____________________________________________

14. I NEED ________________________________________________________

15. I AM __________________________________________________________

16. I WILL ________________________________________________________

17. MY MAIN LIABILITY IS ________________________________________

18. I WILL NOT ___________________________________________________

19. I WAS ________________________________________________________

20. I WISH ________________________________________________________

G. SHORT ANSWER

1. HOW DO YOU SEE YOURSELF?


2. HOW DO YOU THINK OTHERS SEE YOU?


3. HOW WOULD YOU LIKE OTHERS TO SEE YOU?


4. THE MAIN THING I WANT TO LEARN FROM THIS CLASS IS?


5. WHAT DO YOU EXPECT FROM YOUR TEACHER?


6. WHAT DO YOU EXPECT FROM YOURSELF?


7. IF YOU COULD CHANGE ANYTHING ABOUT SCHOOL, WHAT WOULD IT BE?


8. IF YOU COULD CHANGE ANYTHING ABOUT YOURSELF, WHAT WOULD IT BE?


9. WHAT DO YOU LIKE BEST ABOUT YOURSELF?


10. DESCRIBE A GOAL THAT YOU SET FOR YOURSELF AND HOW YOU ACHIEVED IT.



TML