We would like to find out a little more about you and how you feel about school. Your answers to the following questions will help us to do this. It will take you about 15 minutes to complete this survey. If you are unsure of how to answer a question, please answer it as best you can. All the information you provide is confidential. It will only be used to help us learn more about how to keep children interested in completing school.

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* 1. How old are you?

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* 2. What grade are you in?

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* 3. Are you a boy or a girl?

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* 4. What is your race/ethnicity? (please check all that apply):

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* 5. What is your primary language:

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* 6. Second language:

Next you will be asked how much you agree with each of the following statements.

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* 7. I come to class prepared.

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* 8. I treat my classmates with respect.

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* 9. I complete my work on time.

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* 10. I treat my teachers with respect.

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* 11. I follow the rules at school.

Next you will be asked how often the following statements are true for you.

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* 12. I feel excited by the work in school.

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* 13. I am interested in the work I get to do in my classes.

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* 14. I talk with people outside of school about what I am learning.

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* 15. I check my schoolwork for mistakes.

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* 16. I learn a lot from my classes.

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* 17. I enjoy the work I do in class.

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* 18. I feel I can go to my teachers with the things that I need to talk about.

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* 19. My classroom is a fun place to be.

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* 20. Most of my teachers praise me when I work hard.

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* 21. Most of my teachers understand me.

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