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* 1. Race or ethnicity

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* 2. Gender

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* 3. How safe do you feel at school?

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* 4. Are there particular places at school where you do not feel safe? If so, where are they? (check all that apply)

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* 5. Are there certain times of day when these places are unsafe? (select all that apply)

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* 6. This school year, has someone taken money or things directly from you by using force, weapons, or threats?

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* 7. This school year, has someone verbally threatened you at school?

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* 8. If you answered yes on number 7, please specify where this happened to you. (select all that apply)

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* 9. This school year, has someone made sexual advances or attempted to sexually assault you at school?

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* 10. This school year, has someone sexually assaulted you outside of school?

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* 11. This school year, have you seen a student carrying a weapon at school?

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* 12. If you saw a weapon, did you report it?

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* 13. How often have you been bullied, picked on, teased, or harassed at school?

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* 14. How often have you seen others being bullied at school?

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* 15. Have you, without the permission of parents or guardians, consumed alcoholic beverages including beer, wine, or liquor in the past 12 months?

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* 16. Have you used illegal drugs or medications not prescribed by a doctor or approved by a parent?

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* 17. If you answered yes to number 16, please check all that apply.

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* 18. If you have used illegal drugs, how often per week?

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* 19. Have you seen illegal drugs on campus?

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* 20. If you saw illegal drugs, did you report it?

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* 21. In your opinion, how serious are gangs on campus?

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* 22. In your opinion, how serious is alcohol use on campus?

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* 23. In your opinion, how serious is drug use on campus?

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* 24. In your opinion, how serious is drug selling on campus?

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* 25. In your opinion, how serious is carrying weapons on campus?

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* 26. In your opinion, how serious is racial conflict on campus?

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* 27. In your opinion, how serious is bullying on campus?

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* 28. Are you sexually active?

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* 29. If you answered yes to number 28, at what age did you become active?

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* 30. In your opinion, what are the main problems on this campus that relate to the issues addressed in this survey?

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* 31. What are your suggestions for improvement in any of these areas?

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* 32. At my school, teachers respect the students.

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* 33. My teachers care whether I am successful or not.

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* 34. My teachers make me feel good about myself.

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* 35. My parents are proud of me.

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* 36. At my school, teachers are fair to everyone.

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* 37. If I work hard in school, I will be a successful adult.

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* 38. I look forward to coming to school most days.

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* 39. In your opinion, what are the major strengths on this campus that relate to the issues addressed in this survey?

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