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* 1. Please select the building you attend.

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* 2. What grade are you in?

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* 3. I feel like I belong at this school.

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* 4. I feel safe at this school.

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* 5. Adults at this school are respectful to me.

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* 6. I can learn at this school.

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* 7. I can talk to my teachers when I need help with an assignment or to learn something.

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* 8. I can talk to my teacher about problems I might be having.

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* 9. The school gives me the help I need in order to learn.

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* 10. When students display bad behavior, my teachers and/or principal take care of the situation.

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* 11. I believe bullying is a problem at this school.

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* 12. I believe this school handles bullying effectively.

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* 13. I have felt bullied in this school at some point this year.

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* 14. If you generally agree or strongly agree on question number 13, identify the location where you felt bullied this school year. (check all that apply)

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* 15. I use technology in class at least once a week for my learning.

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* 16. I use the Internet to complete my schoolwork outside of school.

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* 17. I access the Internet at home through:

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* 18. Other places in the community where I access the Internet are (check all that apply):

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* 19. I am more engaged in my learning when using technology in class.

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* 20. Overall, I would rate how comfortable I am using a device for schoolwork as:

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* 21. If you would like to leave any additional comments related to school culture and/or technology, please do so in this space.

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