* 1. My teachers

  Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
expect students to do their best
expect me to do my best
are understanding when students have personal problems
set high standards for learning in their classes
help me gain confidence in my ability to learn
know me well
care about me
make learning fun
are excited about the subjects they teach
give me individual attention when I need it

* 2. In my classes, time is spent:

  Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
listening to the teacher talk
in whole class discussion
working in small groups
answering questions from a book or worksheet
working on projects or research
doing work that I find meaningful
using computers/technology

* 3. I learn well when

  Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
I am working on projects or research
the teacher is leading a discussion with the whole class
I am working in a small group
I am working by myself
I am using technology (ipad, computer, etc.)

* 4. I feel ready for the real world, with reference to:

  Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
my ability to write
my ability to read
my ability with mathematics
my ability to process information
my problem solving skills
my ability to work together with peers
my presentation skills
my ability to learn on my own outside of a classroom
my technological skills

* 5. When I am at school, I feel

  Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
I belong.
I am safe.
I have fun learning.
I like this school.
This school is good.
I have freedom at school.
I have choices in the way I learn.
My teacher treats me with respect.
My teacher cares about me.
My teacher thinks I will be successful.
My teacher listens to my ideas.
My principal cares about me.
My teacher is a good teacher.
My teacher believes I can learn.
I am recognized for good work.
I am challenged by the work my teacher asks me to do.
The work I do in class makes me think.
I know what I am supposed to be learning in my classes.
I am a good student.
I can be a better student.
Working hard will make me do well in school.
Very good work is expected at my school.
I behave well at school.
Students are treated fairly by teachers.
Students are treated fairly by the principal.
Students are treated fairly by campus supervisors.
Students at my school treat me with respect.
I like to do things to make my school a great place to be.
I am safe from bullies.
I stand up for people who are picked on or bullied.
I do not pick on or bully others.
I am willing to show kindness to other students.
Students at my school are friendly.
I have lots of friends.
I have lots of support for learning at home.
My family believes I can do well in school.
My family wants me to do well in school.

* 6. Do you have access to a computer at home?

* 7. Do you have a Smart Phone? (A phone that has text messaging, email, and access to the internet)

* 8. Do you have unlimited text messaging on your phone?

* 9. Do you have unlimited access to the internet on your phone?

* 10. Which device do you use most often in order to look up information?

* 11. How often do you use the following whether at school or at home

  Never Monthly Weekly Daily
YouTube
Facebook
Instagram
Twitter
Khan Academy

* 12. How often do you use a computer or mobile device to complete the following tasks?

  Never Once or twice a year Monthly Weekly Almost daily
Play Games
Do Schoolwork
Word Documents
Perform Calculations with a Spreadsheet
Create Presentations
Use the Internet
Communicate through Email
Use tutorials / drill and practice software
Create a Computer Program

* 13. If a teacher decides to create video lessons to watch at home and leave class time for practice, would you be willing to watch the videos on your time?

* 14. My grade level is:

* 15. I am: (select all that apply)

* 16. I am

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