As part of the Grant County College & Career Counseling Initiative, your school is participating in a survey that will help guide their efforts in responding to students' needs regarding social and emotional learning and planning for after high school.

Please complete the following survey and be as open and honest as possible. Even though we ask for your name, it is only to ensure we track what students have completed the survey. Your individual answers will not be seen by any of the staff or teachers at the school. This survey goes directly to an outside consultant who then compiles a summary of the entire school. 

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* 1. Please give your initials.

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* 2. What is your birthdate?

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* 3. What school do you attend?

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* 4. What grade are you in?

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* 5. Please indicate how much you agree with the following statements.

  Not at all Some A lot
At school, there are adults I can talk to, who care about my feelings and what happens to me.
At school, there are adults I can talk to, who give good suggestions and advice about my problems.
At school, there are adults who help me with practical problems, like helping me get somewhere or helping with a project.
There are people in my family I can talk to, who care about my feelings and what happens to me.
There are people in my family I can talk to, who give good suggestions and advice about my problems.
There are people in my family who help me with practical problems, like helping me get somewhere or help me with a job or project.
I have friends I can talk to, who care about my feelings and what happens to me.
I have friends I can talk to, who give good suggestions and advice about my problems.
I have friends who help me with practical problems, like how to get somewhere, or help me with a job.

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* 6. At school, what adults do you feel like you can go to if you had a problem? Check all that apply.

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* 7. Please check if any of the following are making it difficult for you to succeed at school.

  Yes No Don't want to answer
Controlling my anger
Not getting along with others
Fighting
Drugs or alcohol
Stress
Feeling sad most of the time
Getting along with my teachers
Fear of making mistakes
Fear of taking tests

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* 8. Please check if any of the following are making it difficult for you to succeed at school.

  Yes No Don't want to answer
Parents’ divorce or separation
Losing a family member or close friend
Not having enough to eat
Not having a place to sleep

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* 9. Please check if any of the following are making it difficult for you to succeed at school.

  Yes No Don't want to answer
Fear of being physically hurt at school
Fear of being emotionally hurt at school
Fear of coming to school
People harassing, bullying, or gossiping about me

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* 10. If the school offered time to discuss some of the above topics, would you participate? 

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* 11. These questions are about different ways students may behave in school. Please mark the box that best describes you.

  Not at all like me A little like me Somewhat like me A lot like me
I can wait in line patiently.
I sit still when I'm supposed to.
I can wait for my turn to talk in class.
I can easily calm down when excited.
I calm down quickly when I get upset.

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* 12. These next questions are about how well you feel you can do your schoolwork. Mark the box that best describes you.

  Not at all like me A little like me Somewhat like me A lot like me
I can do even the hardest homework if I try.
I can learn the things taught in school.
I can figure out difficult homework.

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* 13. These next questions are about how you get your schoolwork done. Mark the box that best describes you.

  Not at all like me A little like me Somewhat like me A lot like me
If I solve a problem wrong the first time, I just keep trying until I get it right.
When I do badly on a test, I work harder the next time.
I always work hard to complete my school work.

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* 14. These next questions are about how you get your schoolwork done. Mark the box that best describes you.

  Not at all like me A little like me Somewhat like me A lot like me
I do my schoolwork because I like to learn new things.
I do my schoolwork because I'm interested in it.
I do my schoolwork because I enjoy it.

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* 15. Please indicate to what extent you agree or disagree with the following statements about relationships.

  Strongly Disagree Disagree Agree Strongly Agree
Students are kind and supportive of one another.
Students from different social classes and races get along well.
Students stop other students who are unfair or disruptive.
Students get along well together most of the time.
Students respectfully listen to each other during class discussions.
Students make friends easily.
Students enjoy being at school.

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* 16. Please indicate to what extent you agree or disagree with the following statements about relationships.

  Strongly Disagree Disagree Agree Strongly Agree
Teachers treat students with respect.
Teachers praise students more often than they criticize them.
Teachers treat students fairly.
Teachers take the time to help students work out their differences.

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* 17. Please indicate to what extent you agree or disagree with the following statements about relationships.

  Strongly Disagree Disagree Agree Strongly Agree
Students feel free to ask for help from teachers if there is a problem with a student.
Teachers know when students are being picked on or being bullied.
Students are encouraged to report bullying and aggression.
Students know who to go to for help if they have been treated badly by another student.
Students report it when one student hits another.
Teachers take action to solve the problem when students report bullying.
Students report it when one student teases or makes fun of another.

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* 18. Please say if you agree or disagree with the following statements.

  Strongly Disagree Disagree Neutral Agree Strongly Agree
I feel close to people at this school.
I feel like I am a part of this school.
I am happy to be at this school.
The teachers at this school treat students fairly.
I feel safe in my school.

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* 19. Do you expect to graduate high school?

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* 20. Have you thought about what you want to do after high school?

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* 21. Right now, what is your plan for the first year after high school?

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* 22. Do you have someone that you feel comfortable going to with your questions about planning for after high school?

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* 23. How many extra-curricular activities (school, community, or church-related) do you participate in? (Could be sports, clubs, church youth groups or any other activity)

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* 24. What are your top three careers you would want to do when you get older?

0 of 24 answered
 

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