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* 1. What is your FIRST name?

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* 2. What is your LAST name?

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* 3. What grade are you in?

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* 4. At MJHS we hope that you feel that you are valued and cared for as a student. If you do, please check the boxes of ALL of the faculty and staff members that you feel care about you.

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* 5. Please answer the following questions with the choice that most accurately describes your overall feelings.

Overall, I feel as if my teachers care about me.

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* 6. I am proud of my work.

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* 7. I feel that my teachers want me to be successful in class.

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* 8. I feel that teachers value my opinion.

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* 9. I think that my classes work to achieve our mission.

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* 10. I feel encouraged to be creative and think for myself.

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* 11. I believe my teachers are helpful to me.

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* 12. There is a system in place to help me understand and complete my assignments.

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* 13. I set goals for myself to help me achieve at my highest level.

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* 14. I keep data about my progress and improvement.

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