These questions are designed to help you learn more about your students. One side of the handout asks questions regarding reading, and the other side asks questions about writing.
This survey is a quick snapshot of students' habits, strengths, and struggles in reading and writing, and I pass out this survey within the first week of school. Students complete it during the class period.
You can also use this survey for conferences with each student. When I conduct my daily mini-conferences with students, (while the rest of the class is reading silently), these are the first things I ask of them. "Tell me more about your favorite book...", "I see that writing is a struggle for you. Why do you think that is?" etc. (I don't go over all the questions, but choose to highlight a few I would like to have the student to elaborate on. And I take notes right on the handout for future reference.)