Student Background and Goals Questionnaire

This page provides a sample of a student questionnaire in order to learn more about the student’s background and learning goals.


Just like faculty, each student has a unique history of experiences and opportunities that contribute to their engagement and success in the online classroom. It makes sense that each one is at a different stage and will develop at a rate that is consistent with their interests, motivations, personal challenges, and environment. Consider having your students complete a confidential Getting to Know You Survey in the first week of class. This will help you identify your high-need students and help you connect with them. 

  • The Canvas Graded Survey option is used when you want to credit students for completion. Individual questions are not scored.

  • In order to see individual responses, remember to leave the option to Keep Submissions Anonymous unchecked.

  • Number your questions in Canvas to ensure the desired sequence.

  • A lengthy question bank follows. Please review, select, and adapt the instructions, questions, and survey length based on activities and content that are most relevant to your course.

Sample Survey Instructions

Please complete this questionnaire so that I can get to know you better and learn about your goals for this course. I know some of these questions are very personal, and we don’t know each other (yet). I am asking you these questions because I care and want to be able to support you in your learning as best as I can. You may choose to skip any questions you do not feel comfortable answering. Your information will not be shared outside of this course. 

Sample Survey Question Bank

01 - Just Name: What name do you use?

02 - Just Pronouns: What name and pronouns do you use?

03 - Name AND Pronouns: What name and pronouns do you use?

04 - Faculty-Student communication: What is the best way to reach you? (If email, text, or phone, please provide). When is the best time to reach you? 

05 - Voice communications: This semester, I may communicate with you through voice or video messages.

06 - Student's descriptors: Which of the following describes you? (select all that apply).

  • This is my first year of college.

  • I am one of the first generation in my family to attend college.

  • This is my first time taking an online class.

  • I am a caretaker for at least one person.

  • I am taking classes in person this semester.

  • None of the above.

07 - For International students: How many semesters have you studied in the US?

08 - Experience with citations: How familiar to you are these MLA / APA formatting guidelines? Do you feel you can use them today, or would you like support? (add a link to your preferred guidelines).

09 - Experience with citations: How comfortable are you building another person's quote into your own sentence in order to cite it? Would sentence frames help you do this?

10 - Prior experience: What prior experience do you have with the topics described in the syllabus for this course, both personal and academic?

11 - Course goals: What are your goals for this course? What do you want to learn in this class?

12 - Course content: Which of the assigned papers are you least (or most) looking forward to writing, and why?

13 - Why this course: Why are you taking this course?

14 - Feelings about the course: In one word, describe how you are feeling about this class.

15 - Topic discussion experience: Please indicate your experience in discussing topics associated with the topic of this course.

16 - Course content: Which of the learning outcomes for this course are most important to you personally, and why?

17 - Current job: Do you have a job aside from being a student? If so, where do you work and what do you do?

18 - Professional ambitions: What is your professional ambition, at this time?

19 - Hobbies / Interests: What are your hobbies and interests?

20 - Possible interference: What's the one thing that is most likely to interfere with your success in this course? Is there anything you could do to address it?

21 - Internet concerns: Do you have any concerns about having persistent computer or internet access this semester?

22 - Canvas: How many asynchronous online courses have you previously completed? Did you encounter any difficulty completing the Canvas tasks assigned in this module, or locating what you were looking for in this course? 

23 - Working in a group: Think about your experience working in groups. Please select the one response that best suits your experience.

24 - Google Meet or Zoom: Please indicate your level of familiarity with using online video conferencing software such as Zoom, Google Meet, or Skype to meet with someone online in real-time.

25 - Google Docs Experience: Please indicate your level of experience using Google Docs to type, edit, and format documents.

26 - Google Drive: Please indicate your level of familiarity with using Google Docs and Google Drive for collaborative writing and document-sharing activities. For example:

  • Have you used Google docs to co-author a document?

  • Have you created or uploaded a file in Google Drive and shared a link with others to view the file in your Drive?

27 - Blogging: Please indicate your level of familiarity with writing and/or contributing to a blog.

28 - YouTube or Panopto experience: Please indicate your level of success in uploading a video to YouTube or another video hosting site like Panopto, changing video privacy settings to Unlisted, and copying the link to share your video with others.

29 - Credit hours: How many course credit hours are you taking this term?

30 - Extracurricular activities: How many hours each week will you likely be occupied in extracurricular activities such as paid or unpaid (caregiver or volunteer) work, or scheduled activities associated with a club or sport over the term?

31- Planning your weekly schedule INSTRUCTOR: REVIEW DATES AND HOURS: Knowing that the due dates for this course will fall on Tuesdays, Thursdays, and Saturdays, what is your proposed weekly schedule for the 7.5-9 hours for this course?

32 - Invitation to contact the instructor: Is there anything else you'd like to share with me? Please contact me using the method outlined in the syllabus so I am sure to receive this information.

Thank you for sharing your responses to my questions. This information helps me get to know you better and learn about your goals for this course so I can better address them.


Adapted from Sample Student Info Form by Michelle Pacansky-Brock 

Need more help? Try eCampus Center Faculty Development.
Suggest more topics by contacting