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Academic Performance Questionnaire Form Template

Enhance Student Insights with Our Performance Questionnaire

Struggling to gauge your students' academic performance? This questionnaire template helps teachers and administrators collect valuable insights about student achievements and challenges. You can assess learning outcomes, identify areas for improvement, boost engagement, and implement data-driven strategies-all while creating an inclusive environment with WCAG-aligned labels. Explore the live template to start gathering feedback today.

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Full name
Email address
Program or major
Year or level of study
First year
Second year
Third year
Fourth year
Graduate/Professional
Other/Not applicable
How would you rate your current academic performance?
Poor
Fair
Good
Very good
Excellent
How often do you attend scheduled classes or lectures?
Never
Rarely
Sometimes
Often
Always
How often do you submit assignments after the deadline?
Never
Rarely
Sometimes
Often
Always
On average, how many hours per week do you study outside of class?
Less than 3
3-5
6-10
11-15
16-20
More than 20
How often do you review your notes within 24 hours of a class?
Very rarely
Rarely
Sometimes
Often
Very often
Overall, how easy is it for you to manage your study time?
Very difficult
Difficult
Somewhat difficult
Neither easy nor difficult
Somewhat easy
Easy
Very easy
Do you have reliable access to the technology you need for coursework?
Yes
No
Do you have a quiet, distraction-free place to study?
Yes
No
Which types of support would help you most right now?
Please Specify:
Would you like a staff member to follow up with you?
Yes
No
I feel motivated to complete my coursework.
Strongly disagree
Disagree
Neither agree nor disagree
Agree
Strongly agree
How often do you feel overwhelmed by your coursework?
Very rarely
Rarely
Sometimes
Often
Very often
What is your primary academic goal for this term?
What are the main barriers to your academic success, if any?
Please Specify:
Preferred contact method for follow-up (if requested)
Email
Phone
Text message
Video call
In-person
No preference
Do you consent to share your responses with your academic advisor for support purposes?
Yes
No
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Paper art illustration featuring a form template for academic performance assessment and data collection

When to use this form

Use this form at the start of a term to set a baseline and at midterm to spot trends. Teachers and advisors get a clear view of study habits, barriers, and support needs. Use it before parent-teacher meetings to prepare a data-backed plan for each student. After tutoring or study-skills workshops, send it again to measure change. For quick, topic-level check-ins during lessons, pair it with an Exit ticket form. To connect student results with teaching factors, review responses alongside a Simple instructor evaluation form. Department leaders can compare classes and align support, then gather staff context with the Teacher satisfaction survey form.

Must Ask Academic Performance Questionnaire Questions

  1. How many hours did you study outside class for this course last week?

    This quantifies effort and helps you spot gaps between time spent and results. It also guides workload adjustments and time-management coaching.

  2. Which topics or assignments have been most difficult, and why?

    This reveals specific blockers so you can target reteaching or resources. Open reasons surface patterns you might miss in grades alone.

  3. How confident are you that you will meet the learning outcomes by the end of the term?

    Confidence tracks readiness and can predict performance. Low confidence flags students who need quick feedback or support.

  4. Which supports have you used (office hours, tutoring, study group), and how helpful were they?

    This helps you evaluate which services are working and where to invest. It also nudges students to reflect on effective help-seeking.

  5. What is one concrete action you will take next week to improve your performance?

    A specific next step turns reflection into action, which improves follow-through. It creates a commitment you can revisit in later check-ins.

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