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* 1. What is your gender?

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* 2. Which race/ethnicity best describes you? (Please choose only one.)

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* 3. What grade are you in?

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* 4. In my school, programs and services are available to help me succeed. 

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* 5. In my school, the purpose and expectations are clearly explained to me and my family. 

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* 6. In my school, a high quality education is offered. 

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* 7. In my school, all students are treated with respect. 

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* 8. In my school, teachers work together to improve student learning. 

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* 9. In my school, rules are applied equally to all students. 

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* 10. In my school, students treat adults with respect. 

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* 11. In my school, principal and teachers have high expectations of me.

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* 12. My school gives me multiple assessments to check my understanding of what was taught. 

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* 13. My school provides me with challenging curriculum and learning experiences. 

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* 14. My school prepares me to deal with issues I may face in the future. 

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* 15. My school motivates me to learn new things. 

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* 16. My school offers opportunities for my family to become involved in school activities and my learning. 

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* 17. My school makes sure there is at least one adult who knows me well and shows interest in my education and future. 

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* 18. My school provides learning services for me according to my needs. 

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* 19. All of my teachers use a variety of teaching methods and learning activities to help me develop the skills I will need to succeed. 

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* 20. All of my teachers change their teaching to meet my learning needs. 

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* 21. All of my teachers explain their exceptions for learning and behavior so I can be successful. 

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* 22. All of my teachers use tests, projects, presentations, and portfolios to check my understanding of what was taught. 

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* 23. All of my teachers provide me with information about my learning and grades. 

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* 24. All of my teachers keep my family informed of my academic progress. 

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* 25. All of my teachers fairly grade and evaluate my work. 

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* 26. In my school, the building and grounds are safe, clean, and provide a healthy place for learning. 

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* 27. In my school, students respect the property of others. 

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* 28. In my school, a variety of resources are available to help me succeed (e.g, teaching staff, technology, media center).

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* 29. In my school, computers are up-to-date and used by teachers to help me learn. 

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* 30. In my school, students help each other even if they are not friends. 

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* 31. In my school, I can participate in activities that interest me. 

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* 32. In my school, I have access to counseling, career planning, and other programs to help me in school. 

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* 33. My school shares information about school success with my family and community members. 

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* 34. My school considers students' opinions when planning ways to improve the school. 

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* 35. My school prepares me for success in the next school year. 

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* 36. What do you like best about our school?

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* 37. What do you like least about our school?

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