Student Background Assessment Form
Student Background Assessment Form
Full Name
*
First Name
Last Name
Current Academic Program or Major
*
Year or Level of Study
*
Please Select
First Year
Second Year
Third Year
Fourth Year
Graduate
Other
Briefly describe your previous academic background or qualifications.
*
Current Learning Environment
*
On-campus
Online/Remote
Hybrid
Other
What are your main academic or learning goals for this term?
*
How confident do you feel about achieving your academic goals?
*
1
2
3
4
5
Please indicate your agreement with the following statements:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
I have effective study strategies.
1
2
3
4
5
I feel supported by my learning environment.
6
7
8
9
10
I am motivated to succeed academically.
11
12
13
14
15
I know where to seek help if needed.
16
17
18
19
20
What academic skills or areas would you like additional support with?
*
Time management
Note-taking
Exam preparation
Writing
Reading comprehension
Research skills
Other
Is there anything else you would like to share about your learning background or support needs?
Submit Assessment
Should be Empty: