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Middle School - Guidance Curriculum Assessment
PARENT SURVEY

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* 1. Student’s Name:

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* 2. Parent’s Name:

ACADEMIC DEVELOPMENT
Please rate your student’s ability to accomplish the following ASCA Standards Indicators.
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* 3. Takes pride in work and in achievement

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* 4. Displays a positive interest in learning

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* 5. Applies time management and task management skills

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* 6. Applies the study skills necessary for academic success

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* 7. Demonstrates the ability to balance school, studies, extracurricular activities, leisure time, and family life

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* 8. Has a positive attitude toward work and learning

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* 9. Has an awareness of personal abilities, skills, interests, and motivations

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* 10. Understands the importance of planning

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* 11. Has hobbies and work interests

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* 12. Understands the relationship between educational achievement and career success

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* 13. Understands how work can help to achieve personal success and satisfaction

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* 14. Identifies values, attitudes, and beliefs

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* 15. Understands change as a part of growth

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* 16. Uses effective communication skills

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* 17. Has effective coping skills for dealing with problems

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* 18. Differentiates between situations requiring peer support and situations requiring adult professional help

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* 19. Applies effective problem-solving and decision making sills to make safe and healthy choices

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* 20. Understands the physical dangers of substance use and abuse

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* 21. Knows how to cope with peer pressure

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* 22. Takes responsibility for actions at home

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* 23. Assists with household duties (chores)

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* 24. Participates in the care of someone else or thing (pet, sibling, plant, etc.)

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* 25. Goes to bed on time

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* 26. Keeps personal area tidy (e.g. bedroom)

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