2019-2020 Survey

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* 1. FIRST NAME and LAST NAME

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* 2. What is your gender?

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* 3. What grade are you in?

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* 4. TEAM

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* 5. Do you worry about any of these items?

  Never Sometimes Often
Being teased or made fun of at school by peers
Being liked by my teachers
Getting all of my homework done
Getting good grades
Taking tests
Doing well on a sports team
Disappointing my family
Family problems
My health
How I look
My weight
Having friends
Finding a seat or table in the cafeteria
Having personal items taken from school
Making poor choices to fit in
Drugs or alcohol in the middle school
Your friends using drugs or alcohol
Your family using drugs or alcohol
You or your friends participating in self-harm

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* 6. Do you participate in any after-school sports or clubs here at the middle school?

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* 7. Do you participate in any community-based activities (sports, church, lessons, scouts, etc.)?

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* 8. How many days of the week do you stay after school for extra help from teachers?

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* 9. Do you feel that you have friends in middle school?

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* 10. How many adults in the middle school could you talk to about a problem or share good news?

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