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* 1. What year were you born?

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* 2. What grade are you currently in at school for 2019-2020?

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* 3. Which community do you live in?

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* 4. Do you feel what you have learned or are learning at school is preparing you for adulthood?

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* 5. Do you like spending time at home?

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* 6. Do you feel safe in your neighborhood?

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* 7. Do you have a good friend or trusted adult (for example: a parent, aunt, uncle grandparent, teacher, counselor, etc.) you can count on?

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* 8. Do you know what to do if you, a member of your family or a friend are in a crisis situation?

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* 9. Has anyone pressured you for sexual contact, or attempted sexual activity with you without your consent, including touching, hugging, or kissing?

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* 10. Have you used any drugs and/or alcohol in the last month?

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* 11. What was your assigned sex at birth?

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* 12. How do you gender identify?

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* 13. How do you identify culturally including sexual orientation?

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* 14. If you could give advice to yourself when you started school, what would you say?

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* 15. What would you like to say to the decision-makers, local, state, national or international, whose actions can impact your future?

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