H.I.B. Student Survey Grades 1-5H.I.B. Student Survey Grades 1-5

1. Are you a boy or a girl?

Are you a boy or a girl? Boy

Girl

2. What grade are you in?

What grade are you in? Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

3. I look forward to coming to school?

I look forward to coming to school? Yes

4. This is how much I like the children in my school:

This is how much I like the children in my school: I like them alot

I don't like them at all

5. In my school, I feel:

	Most of the time	Sometimes	Never
Happy	*In my school, I feel: Happy Most of the time	Happy Sometimes	Happy Never
Interested	Interested Most of the time	Interested Sometimes	Interested Never

6. In my school, I feel:

7. The children in my school:

	Alot	OK	Not very much
Like Each Other	*The children in my school: Like Each Other Alot	Like Each Other OK	Like Each Other Not very much
Respect Each Other	Respect Each Other Alot	Respect Each Other OK	Respect Each Other Not very much

8. The adults in my school care about me

The adults in my school care about me Alot

Not very much

9. There is at least one adult at school that I can go to for help when something is bothering me:

There is at least one adult at school that I can go to for help when something is bothering me: Yes

Not Sure

10. How often does this happen to you in your school?

	Never	Sometimes	Alot
Another child in this school says something nice to me	*How often does this happen to you in your school? Another child in this school says something nice to me Never	Another child in this school says something nice to me Sometimes	Another child in this school says something nice to me Alot
Another child in this school says something mean to me	Another child in this school says something mean to me Never	Another child in this school says something mean to me Sometimes	Another child in this school says something mean to me Alot
Another child in this school teases me	Another child in this school teases me Never	Another child in this school teases me Sometimes	Another child in this school teases me Alot
Another child in this class won't let me join in activities	Another child in this class won't let me join in activities Never	Another child in this class won't let me join in activities Sometimes	Another child in this class won't let me join in activities Alot

11. How often do you say something nice to someone in your class?

How often do you say something nice to someone in your class? Alot

Sometimes

Never

12. How often does this happen to you in your school?

	Never	Sometimes	Alot
Say something mean to someone in your school?	*How often does this happen to you in your school? Say something mean to someone in your school? Never	Say something mean to someone in your school? Sometimes	Say something mean to someone in your school? Alot
Tease someone in your school?	Tease someone in your school? Never	Tease someone in your school? Sometimes	Tease someone in your school? Alot
Not let someone in your school join an activity?	Not let someone in your school join an activity? Never	Not let someone in your school join an activity? Sometimes	Not let someone in your school join an activity? Alot

13. How often does this happen to you?

	Never	Sometimes	Alot
Another child is mean to me on the bus	*How often does this happen to you? Another child is mean to me on the bus Never	Another child is mean to me on the bus Sometimes	Another child is mean to me on the bus Alot
Another child teases me on the bus	Another child teases me on the bus Never	Another child teases me on the bus Sometimes	Another child teases me on the bus Alot
Another child will not allow me to sit with him or her on the bus	Another child will not allow me to sit with him or her on the bus Never	Another child will not allow me to sit with him or her on the bus Sometimes	Another child will not allow me to sit with him or her on the bus Alot
Another child is mean to me at recess	Another child is mean to me at recess Never	Another child is mean to me at recess Sometimes	Another child is mean to me at recess Alot
Another child teases me at recess	Another child teases me at recess Never	Another child teases me at recess Sometimes	Another child teases me at recess Alot
Another child will not allow me to play with him or her at recess	Another child will not allow me to play with him or her at recess Never	Another child will not allow me to play with him or her at recess Sometimes	Another child will not allow me to play with him or her at recess Alot

14. This is how safe I feel in each of these places:

	Very Safe	OK	Not Safe
On the playground	*This is how safe I feel in each of these places: On the playground Very Safe	On the playground OK	On the playground Not Safe
In the hallways	In the hallways Very Safe	In the hallways OK	In the hallways Not Safe
On the bus	On the bus Very Safe	On the bus OK	On the bus Not Safe
In the cafeteria	In the cafeteria Very Safe	In the cafeteria OK	In the cafeteria Not Safe
In the gym	In the gym Very Safe	In the gym OK	In the gym Not Safe

15. Do you feel safe talking to an adult in your school

Do you feel safe talking to an adult in your school Yes

H.I.B. Student Survey Grades 1-5Exit this survey