This survey is your way to give your input. Your name does not go on this survey, so it will be anonymous. Please make sure your answers are thoughtful. We want to know what you really think.

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* 1. Grade Level

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* 2. Gender

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* 3. When I am at school I feel like I have friends.

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* 4. When I am at school I feel like other students are friendly. (Including on the bus, in the halls, at recess and lunch, and kids in other grades.)

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* 5. When I am at school I feel like I belong.

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* 6. When I am at school I feel like the adults are caring and respectful.

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* 7. When I am at school I feel like if I have a problem (conflict) with another student I can get help from an adult if I need it.

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* 8. When I am at school I feel like I am safe in my classroom.

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* 9. When I am at school I feel like I am safe at recess and lunch.

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* 10. When I am at school I feel like I am safe in the halls and bathrooms.

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* 11. I feel like I am safe on the school bus going to and from school.

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* 12. When I am at school I feel the work I do in class makes me think.

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* 13. When I am at school I feel I can get help with my classwork from the adults if I need it.

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* 14. When I am at school I feel that adults care about my learning.

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* 15. When I am at school I feel I get recognized for good work or good behavior.

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* 16. When I am at school I feel that if I have a problem or worry there is at least one adult I could talk to if I wanted.

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* 17. I think that homework helps me learn.

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* 18. The amount of homework I have is ...

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* 19. The homework that helps me learn the most is....

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* 20. Tell us about any homework that does not help you learn (if any)

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* 21. One thing I like most about HES is...

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* 22. One thing I would change about HES is...

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