Your Full Name

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* 1. Your Full Name

Your School

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* 2. Your School

Your Learning Center

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* 3. Your Learning Center

Your Teacher's Name

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* 4. Your Teacher's Name

How long have you been at your school?

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* 5. How long have you been at your school?

What instructor has made the biggest change in your life? How did he or she do it?

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* 6. What instructor has made the biggest change in your life? How did he or she do it?

What is your proudest accomplishment related to school? Be specific about what you accomplished.

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* 7. What is your proudest accomplishment related to school? Be specific about what you accomplished.

What is your favorite memory from your school? Please describe below.

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* 8. What is your favorite memory from your school? Please describe below.

Would you recommend this school to others? Choose Yes or No, and explain.

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* 9. Would you recommend this school to others? Choose Yes or No, and explain.

Do you feel you have been successful at your school? In what ways? Be specific.

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* 10. Do you feel you have been successful at your school? In what ways? Be specific.

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