The person appears to be a/an Middle Eastern Male, approximately 10 to 19 years old.
Sure! Here’s a simple survey template you can use: 

1. How would you rate your understanding of the topic discussed in class? (1 = Poor, 5 = Excellent)
2. What aspects of the topic did you find most interesting?
3. Do you think we should explore this topic further? (Yes/No)
4. Any additional comments or suggestions?

Feel free to modify the questions to better fit your needs!
Here's a simple survey you can use: 'What is your favorite hobby? Please choose one of the following options: 1. Sports 2. Video Games 3. Music 4. Art 5. Other (please specify)'. You can also add a question about why they enjoy that hobby to get more insights!