Student Questionnaire by PRS5NYB


									                            Student Questionnaire
                             Peer Tutor Program

1.    Name:                                  Date ____/____     /2005

2.    Student number:                        Date of birth: ____/____/_______

3.    Program and Year Level:


            a.     Phone        i.    Home

                                ii.   Mobile

            b.     Email

            c.     Postal address

5a.   Which peer tutoring option would you like to participate in?

            - metropolitan placement (half day visit for 10 weeks) OR

            - regional trip (5 days in Feb, June/July or Nov/Dec uni break) OR

            - Siemens Science Experience (3 days over January break)

5b.   Which time of year would you wish to participate in the program?

            - Semester 1 or 2 for metropolitan placement

            - Feb or June/July or Nov/Dec regional trip?

6.    If you are interested in the metropolitan peer tutor program would you
      prefer to help in a primary or secondary school?

      Are there any schools in particular that you would like to visit?

      Is this your old School? Yes/No
7.    If you want to become involved in the intensive (regional trip or Siemens)
      Peer Tutor Program, tell us why in 20 words or less (other than it is a good
      way to get a context course out of the way)?

8a.   What subjects did you study in Year 12?

8b.   Which secondary school did you go to?

8c.   What subjects do you feel that you could confidently teach Grade 3 to Year
      10 students?

9.    Have you had any experience in peer support or cross-age tutoring in the
      past? If yes, explain.

10.   Have you ever considered teaching as a future career option? Yes/No

11.   What do you think are the main community benefits of the Peer Tutor

12.   What do you think are the main reasons for having Peer Tutors in schools?
13.       What skills do you believe are needed to be a successful peer tutor?

14.       What do you believe is the key ingredient to successful teamwork?

15.       What do you think the most challenging part of the Peer Tutor Program will
          be for yourself?

16.       Any questions?

         Please return this form to Louise Delpratt, Peer Tutor Program Manager.
         Please Note: Enrolments cannot be done on-line.
         We will contact you prior to enrolment.

Thank you for your time.
If you require any further information contact Louise Delpratt (9925 4987) or Nick Besley (9925 4988)

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