Directions: Please complete all of the following sentences regarding the class that you are focusing on for this program. There are no right or wrong answers. Put down the first idea that comes into your head. When you are done, give this form back to your teacher/counselor.

1. When I try hard in this class, it’s because _____________________________.

2. I would spend more time on my schoolwork if _________________________.

3. If I do poorly in this class, then ____________________________________ (will happen).

4. When I don’t try hard in this class, it’s because ____________________.

5. Doing well in this class will help me to ________________________.

6. This class is important because ________________________________.

7. The thing that I am most interested in learning more about is ________________.

8. The most interesting thing that I learned in _______ class this year is _________________.

9. I feel best about myself when _______________________________________.

10. I feel worst about myself when _____________________________________.

11. I am most proud of _____________________________________________.

12. I wish that I could ______________________________________________.

13. When I grow up, I want to ________________________________________.

14. I really value ___________________________________________________.