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#Unfiltered-Truth Survey for Middle School Students
Only fill out this survey if you are a Middle School
student
*
1.
What is today's date?
(Required.)
Date
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
2.
What was the date of your
first
#Unfiltered-Truth session?
(Required.)
Date / Time
Date
January
February
March
April
May
June
July
August
September
October
November
December
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
Su
Sunday
Mo
Monday
Tu
Tuesday
We
Wednesday
Th
Thursday
Fr
Friday
Sa
Saturday
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
*
3.
How old are you?
(Required.)
14
15
16
17
18
19
*
4.
What grade are you in?
(Required.)
7th
8th
*
5.
What is your race?
(Required.)
White
Black or African American
Hispanic or Latino
Asian or Asian American
Other
*
6.
What is your gender?
(Required.)
Male
Female
*
7.
How many #Unfiltered-Truth classes did you attend?
(Required.)
1
2
3
4
5 or more
*
8.
Select the activities/lessons that impacted you the most. (You can choose more than one. You may not have had some of the lessons listed.)
(Required.)
Friendship Lessons
Personality Profile
Love languages
Refusal Skills
Pornography Effects
*
9.
How many times did you talk to a parent or trusted adult about these sessions or work on activities together?
(Required.)
0
1
2
3 or more
10.
Please rate the #Unfiltered-Truth teachers
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
They kept my attention and made learning fun.
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
They used their time well.
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
I would recommend the #Unfiltered-Truth teachers to others
Strongly Disagree
Disagree
Unsure
Agree
Strongly Agree
*
11.
Would you like more relationship skills classes?
(Required.)
Yes
No
12.
Why or why not?
13.
What other topics should be included?
*
14.
Should any topics be removed? Please tell us why
(Required.)
*
15.
How did you feel about the overall presentation?
(Required.)
Extremely valuable
Very valuable
Somewhat valuable
Not so valuable
Not at all valuable
*
16.
Please answer
at least one
of these questions:
*What would you tell a friend or family member about these classes?
*How will these classes affect your future?
*What feedback will you give your regular teacher about these classes?
(Required.)
