Exit this survey Copy of BCHS Safe and Drug Free Survey 16-17 1. Question Title * 1. Grade in school 9th 10th 11th 12th Question Title * 2. Race or ethnicity White African American Native American Hispanic Other Question Title * 3. Gender Boy Girl Question Title * 4. How safe do you feel at school? very safe safe unsafe Question Title * 5. Are there particular places at school where you do not feel safe? If so, where are they? (check all that apply) classrooms lunchroom stairwells parking lot restrooms school bus hike and bike trail gym/locker room area I feel safe Other (please specify) Question Title * 6. Are there certain times of day when these places are unsafe? (select all that apply) before school during class during lunch after school entire school day I feel safe at all times Other (please specify) Question Title * 7. This school year, has someone taken money or things directly from you by using force, weapons, or threats? never one or two times three to four times more than four times Question Title * 8. This school year, has someone verbally threatened you at school? never one or two times three to four times more than four times Question Title * 9. If you answered yes on number 8, please specify where this happened to you. (select all that apply) at school to or from school on a school bus on a school sponsored activity This has not happened to me Other (please specify) Question Title * 10. This school year, has someone made sexual advances or attempted to sexually assault you at school? never one or two times three to four times more than four times Question Title * 11. This school year, has someone sexually assaulted you outside of school? never one or two times three to four times more than four times If yes, name the location. Question Title * 12. This school year, have you seen a student carrying a weapon at school? yes no If yes, explain. Question Title * 13. If you saw a weapon, did you report it? yes no Question Title * 14. How often have you been bullied, picked on, teased, or harassed at high school? never once in a while frequently daily Question Title * 15. How often have you seen others being bullied at school? never once in a while frequently daily If yes, please explain. Question Title * 16. Have you, without the permission of parents or guardians, consumed alcoholic beverages including beer, wine, or liquor in the past 12 months? yes no Question Title * 17. Have you used illegal drugs or medications not prescribed by a doctor or approved by a parent? yes no Question Title * 18. If you answered yes to number 17, please check all that apply. marijuana Kush cocaine crack ecstasy heroine Xanax/Hydrocodone/Couch Syrup not prescribed by a doctor other I do not use illegal drugs or drugs not prescribed by a doctor. Question Title * 19. If you have used illegal drugs, how often per week? one to two times three to four times five to six times more than six times does not apply to me Question Title * 20. Have you seen illegal drugs on campus? yes no If yes, please explain. Question Title * 21. If you saw illegal drugs, did you report it? yes no does not apply to me If no, please report here. Question Title * 22. In your opinion, how serious are gangs on campus? don't know no problem small problem serious problem Question Title * 23. In your opinion, how serious is alcohol use on campus? don't know no problem small problem serious problem Question Title * 24. In your opinion, how serious is drug use on campus? don't know no problem small problem serious problem Question Title * 25. In your opinion, how serious is drug selling on campus? don't know no problem small problem serious problem Question Title * 26. In your opinion, how serious is carrying weapons on campus? don't know no problem small problem serious problem Question Title * 27. In your opinion, how serious is racial conflict on campus? don't know no problem small problem serious problem Question Title * 28. In your opinion, how serious is bullying on campus? don't know no problem small problem serious problem Question Title * 29. Are you sexually active? yes no Question Title * 30. If you answered yes to number 29, at what age did you become active? 14 or younger 15 16 17 18 Does not apply to me Question Title * 31. In your opinion, what are the main problems on this campus that relate to the issues addressed in this survey? Question Title * 32. What are your suggestions for improvement in any of these areas? Question Title * 33. At my school, teachers respect the students. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 34. My teachers care whether I am successful or not. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 35. My teachers make me feel good about myself. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 36. My parents are proud of me. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 37. At my school, teachers are fair to everyone. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 38. If I work hard in school, I will be a successful adult. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 39. I look forward to coming to school most days. Strongly Disagree Disagree Not Sure Agree Strongly Agree Question Title * 40. In your opinion, what are the major strengths on this campus that relate to the issues addressed in this survey? Done