1. Student Behaviors

The purpose of this survey is to determine whether regular attendees’ behavior improved or did not improve in certain areas due to the Greenwood Leflore School District's 21st CCLC project. Regular attendees are students who have attended the program 30 days or more during the school year.

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* 1. Teacher Name:

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* 2. Please enter today's date:

Date

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* 3. What school do you currently teach primarily?

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* 4. Select the grade level of your students.

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* 5. Subject(s) taught if students taught were at middle or high school level:

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* 6. Over the past school year, rate the following statements for the majority of your students on the average.

  Improved Maintained Acceptable Level Declined
Turning in her/his homework on time
Completing homework to your satisfaction
Participating in class
Volunteering (e.g., for extra credit or more responsibilities)
Attending class regularly
Being attentive in class
Behaving well in class
Classroom academic performance
Coming to school ready/prepared to learn
Getting along well with other students
Thank you for your participation in this survey!

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