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Total questions: 22

Worksheet time: 44mins

Name
Class
Date
1.

How are you feeling today?

a)

Happy

b)

Sad

c)

Mad

d)

Tired

2.

What do you LIKE about distance learning?

4 lines
3.

What do you not like about distance learning?

4 lines
4.

Which is true?

a)

I know what to do when I'm stressed.

b)

I do NOT know what to do when I'm stressed.

5.

The color that makes me smile MOST is...

a)

Blue

b)

Yellow

c)

Orange

d)

Pink

e)

Purple

6.

The most important thing I want you to know about me right now is...

4 lines
7.

What do you miss about being in the school building instead of learning at home?

4 lines
8.

Which do you like best?

a)
b)
c)
d)
9.

What do you need to work on as person for remote learning? (Ex: being on time, participating in class discussions, doing the work, ask questions, etc.)

4 lines
10.

Which do you like?

a)
b)
c)
d)
11.

How are you in regards to technology for distance learning? (No right answer and choose whichever one(s) apply)

a)

Still all good and able to log on

b)

WiFi issues

c)

Device issues (Ipad, computer, phone, laptop, etc.)

d)

Unable to access my homework (Plaso, CommonLit, ReadTheory)

12.

Which part of English class are you having the most difficulty with?

a)

Turning in the correct homework on time

b)

Completing work with high quality

c)

I feel like things are too easy for me

d)

Understanding assignments

e)

Speaking practice during class

13.

In your head, think of a few things you are grateful for today. Why do you think it's important for us to stop and notice what we are grateful for?

a)

It helps us feel happier.

b)

It helps us appreciate what we have right now.

c)

It helps us feel less stressed.

d)

It helps us act more kindly toward others.

14.

It's important to set goals to help us focus, make good choices, and boost our confidence. Think of a goal you want to work toward today.

a)

I know what my goal is for today!

b)

I need help creating a goal for today.

15.

When you feel upset or irritated today, what strategy can you use to calm yourself?

a)

Take 5 deep breaths.

b)

Count forward to 10 then back.

c)

Picture a happy place in my mind.

d)

Some other strategy.

16.

Which superpower would you choose?

a)

flight

b)

invisibility

c)

super strength

d)

super intelligence

e)

breath under water

17.

What is your biggest success in school right now? (In other words, what is something you're really good at in school?)

4 lines
18.

What is your favorite activity to do right now?

4 lines
19.

What are you going to do when school ends today?

4 lines
20.

How will you work to improve your English abilities in the next 7 weeks?

4 lines
21.

Would you like extra Common Lit work for pink notes?

a)

Yes, please!

b)

No thanks, I'm good.

c)

Common Lit isn't great for me...maybe I could do some other work?

d)

I'd prefer to work on my speaking!

22.

Is there anything else you'd like me to know?

4 lines