* 1. I attend:

* 2. Choose your grade level

* 3. Gender

* 4. Are you new to your school building this year?

* 5. Select the response that best fits your feelings about the statement:

  Strongly Agree Agree Disagree Strongly Disagree
Teachers in my school care about me.
My teachers are available when I need extra help.
The teachers in my school treat me with respect.
I feel physically safe in my classrooms.
I feel emotionally safe in my classrooms.
I feel physically safe outside the classroom while at school (cafeteria, restrooms, hallways, lockers, playground, etc.)
My teachers give helpful feedback and encouragement.
My teachers work well together.
I enjoy coming to school.
I have a positive relationship with at least one adult at my school.
I trust a majority of the teachers in my school.
I trust a majority of the adults, other than teachers, in my school.
I feel like I learn when I am at school.
I like going to school events, such as sports, dances, etc.
I participate in activities at my school such as teams, clubs, etc.
My classmates treat me with respect.