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Pre-test - Participants

Question Title

* 1. Date of survey administration

Date

Date

Question Title

* 2. Respondent details

First Name

Last name

Question Title

* 3. Please circle the number closest to how true you feel the statement to be …

	Not at all true		Somewhat true		Very true
I am important to the community.	I am important to the community. Not at all true	I am important to the community.	I am important to the community. Somewhat true	I am important to the community.	I am important to the community. Very true
I feel good about myself because I help others.	I feel good about myself because I help others. Not at all true	I feel good about myself because I help others.	I feel good about myself because I help others. Somewhat true	I feel good about myself because I help others.	I feel good about myself because I help others. Very true
I know people in the community that care about me.	I know people in the community that care about me. Not at all true	I know people in the community that care about me.	I know people in the community that care about me. Somewhat true	I know people in the community that care about me.	I know people in the community that care about me. Very true
I try to help when I see people in need.	I try to help when I see people in need. Not at all true	I try to help when I see people in need.	I try to help when I see people in need. Somewhat true	I try to help when I see people in need.	I try to help when I see people in need. Very true

Question Title

* 4. Please circle the number closest to how true you feel the statement to be …

	Not at all true		Somewhat true		Very true
I am comfortable being around people who have different abilities than me.	I am comfortable being around people who have different abilities than me. Not at all true	I am comfortable being around people who have different abilities than me.	I am comfortable being around people who have different abilities than me. Somewhat true	I am comfortable being around people who have different abilities than me.	I am comfortable being around people who have different abilities than me. Very true
I am confident in my ability to make friends with people of all abilities.	I am confident in my ability to make friends with people of all abilities. Not at all true	I am confident in my ability to make friends with people of all abilities.	I am confident in my ability to make friends with people of all abilities. Somewhat true	I am confident in my ability to make friends with people of all abilities.	I am confident in my ability to make friends with people of all abilities. Very true
I have a group of friends that I can count on.	I have a group of friends that I can count on. Not at all true	I have a group of friends that I can count on.	I have a group of friends that I can count on. Somewhat true	I have a group of friends that I can count on.	I have a group of friends that I can count on. Very true
I understand that someone who looks or sounds different than me may not be that different after all.	I understand that someone who looks or sounds different than me may not be that different after all. Not at all true	I understand that someone who looks or sounds different than me may not be that different after all.	I understand that someone who looks or sounds different than me may not be that different after all. Somewhat true	I understand that someone who looks or sounds different than me may not be that different after all.	I understand that someone who looks or sounds different than me may not be that different after all. Very true
I work well with others on a team.	I work well with others on a team. Not at all true	I work well with others on a team.	I work well with others on a team. Somewhat true	I work well with others on a team.	I work well with others on a team. Very true

Question Title

* 5. Please circle the number closest to how true you feel the statement to be …

	Not at all true		Somewhat true		Very true
I am good about handling whatever comes my way.	I am good about handling whatever comes my way. Not at all true	I am good about handling whatever comes my way.	I am good about handling whatever comes my way. Somewhat true	I am good about handling whatever comes my way.	I am good about handling whatever comes my way. Very true
I am good at learning new things.	I am good at learning new things. Not at all true	I am good at learning new things.	I am good at learning new things. Somewhat true	I am good at learning new things.	I am good at learning new things. Very true
I am good at solving problems.	I am good at solving problems. Not at all true	I am good at solving problems.	I am good at solving problems. Somewhat true	I am good at solving problems.	I am good at solving problems. Very true
I am good at trying new activities.	I am good at trying new activities. Not at all true	I am good at trying new activities.	I am good at trying new activities. Somewhat true	I am good at trying new activities.	I am good at trying new activities. Very true
I believe I am able to do things as well as most people.	I believe I am able to do things as well as most people. Not at all true	I believe I am able to do things as well as most people.	I believe I am able to do things as well as most people. Somewhat true	I believe I am able to do things as well as most people.	I believe I am able to do things as well as most people. Very true
I believe I have a number of good qualities.	I believe I have a number of good qualities. Not at all true	I believe I have a number of good qualities.	I believe I have a number of good qualities. Somewhat true	I believe I have a number of good qualities.	I believe I have a number of good qualities. Very true
I feel good about my future.	I feel good about my future. Not at all true	I feel good about my future.	I feel good about my future. Somewhat true	I feel good about my future.	I feel good about my future. Very true
I feel good about myself.	I feel good about myself. Not at all true	I feel good about myself.	I feel good about myself. Somewhat true	I feel good about myself.	I feel good about myself. Very true
I feel that I have control over things that happen to me	I feel that I have control over things that happen to me Not at all true	I feel that I have control over things that happen to me	I feel that I have control over things that happen to me Somewhat true	I feel that I have control over things that happen to me	I feel that I have control over things that happen to me Very true