DCNEO HS/MS Cultural Climate Survey Question Title * 1. With which of the following genders do you identify? Check all that apply: Female Male Transgender Genderqueer Agender Self-identify (please specify):____________________ Prefer not to answer OK Question Title * 2. What is your sexual orientation? Check all that apply: Asexual Bisexual Fluid Gay Heterosexual Lesbian Queer Questioning Self-identify (please specify):____________________ Prefer not to answer OK Question Title * 3. With which of the following races/ethnicities do you identify? Check all that apply: North American Indigenous (e.g., Navajo Nation, Blackfeet Tribe, or Inupiat Traditional Govt., etc.) Asian or Asian American (e.g., Chinese, Japanese, Filipino, Korean, South Asian, Vietnamese, etc.) African, Black, or African American (e.g., Jamaican, Nigerian, Haitian, Ethiopian, etc.) Hispanic or Latinx (e.g., Puerto Rican, Mexican, Cuban, Salvadoran, Colombian, etc.) Middle Eastern or North African (e.g., Lebanese, Iranian, Egyptian, Moroccan, etc.) Native Hawai'ian or Pacific Islander (e.g., Samoan, Guamanian, Chamorro, Tongan, etc.) White (e.g., German, Irish, English, Italian, Polish, French, etc.) Prefer not to answer Other (please specify) OK Question Title * 4. Do you have a disability? Check all that apply: Autism/autism spectrum Emotional or psychological Hearing impairment Orthopedic impairment Specific learning disability Speech or language impairment Traumatic brain injury Visual impairment Prefer not to answer Other (please specify) OK Question Title * 5. My favorite kind of music is... EDM Rock Pop Hip Hop/Rap R&B Country Other Genres I love all music I don't like music...at all ???? OK Question Title * 6. During this school year, I've had mean or hurtful things said to me by another student(s). True False OK Question Title * 7. During this school school year, I have been targeted negatively at school based on which of the following elements: Body size, Shape, & Skills Physical Diability Learning Differences Gender Identity LGBTQ (Sexual Orientation) Immigration Status (Nationality/Language) Race & Ethnicity Religion Family Financial Status None OK Question Title * 8. During this school year, I've said hurtful things to other students in school. (seriously and/or jokingly) True False OK Question Title * 9. During this school year, I've had mean or hurtful things said to me online by another student(s). (seriously and/or jokingly) True False OK Question Title * 10. During this school year, I have been targeted negatively online based on which of the following elements: Body Size, Shape, & Skills Physical Disability Learning Differences Gender Identity LGBTQ (Sexual Orientation) Immigration Status (Nationality/Language) Race & Ethnicity Religion Family Financial Status None OK Question Title * 11. During this school year, I have heard student(s) targeted at school for which of the following elements: Body Size, Shape, & Skills Physical Disability Learning Differences Gender Identity LGBTQ (Sexual Orientation) Immigration Status (Nationality/Language) Race & Ethnicity Religion Family Financial Status None OK Question Title * 12. During this school year, I have heard student(s) targeted online for which of the following elements: Body Size, Shape, & Skills Physical Disability Learning Differences Gender Identity LGBTQ (Sexual Orientation) Immigration Status (Nationality/Language) Race & Ethnicity Religion Family Financial Status None OK Question Title * 13. During this school year, I've said mean or hurtful things online to another student(s). True False OK Question Title * 14. During this school year, I've wanted to stay home from school to avoid a conflict, rumor, or being made fun of by another student(s). 0 times 1-3 times 4-5 times more than 5 times more than 10 times OK Question Title * 15. During this school year, in my school or community I have noticed vandalism that expresses hate in any form to minority groups. True False OK Question Title * 16. How confident do you feel in your ability to stand up to negative comments, name calling, bullying, & teasing? Extremely Somewhat Not at all OK Question Title * 17. I stand up for others when they are bullied at school. True False OK Question Title * 18. I stand up for others when they are bullied online. True False OK Question Title * 19. What diversity topics do you feel need to be addressed more at school? Body Image & Stigma (Dis)Ability Gender LGBTQ Immigration Race & Ethnicity Religious Tolerance Socioeconomics (SES) Leadership Bullying Prevention/Cyberbullying Other (please specify) OK DONE