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* 1. Are you:

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* 2. What is your grade level?

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* 3. What is your ethnicity?

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* 4. Do you receive free or reduced price nutrition/lunch at school?

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* 5. What is your level of English?

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* 6. What language do you speak at home?

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* 7. Please rate the following statements on a scale from strongly agree to strongly disagree.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The purpose of this school is learning. 
In this school, students are taught how to evaluate their own work. 
All students are expected to complete their assigned work.
Parents volunteer in my classroom.
The principal observes my class frequently.
In my classroom, students are given enough time to learn.    
In my school, there are clear and stated rules for behavior.
I believe my school is a good place for learning.
My teachers regularly discuss my progress with me and show me how to do well in school.
My teachers have high expectations for my performance at school.

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* 8. Please rate the following statements on a scale from strongly agree to strongly disagree.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The participation of parents at school is important for student learning.
In my school there are programs for students who need help.
In my school, all students are disciplined fairly.
One goal of this school is to help us understand different cultures.
My teachers use many ways to learn about my learning style.
My teachers expect all students to complete assignments and schoolwork.
My parents communicate with my teachers about my learning and progress.
The principal and counselor talk with my teachers about instruction and student learning.
My teachers assist students who need extra help.
My school is a safe and secure place to learn.

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* 9. Please rate the following statements on a scale from strongly agree to strongly disagree.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
My school's mission emphasizes learning for all students. 
We have tests every 6-8 weeks to measure our progress.
My school displays student work in the classrooms.
The principal recognizes students for appropriate behavior.
In my classroom, students work together to help each other learn.
The school is always kept clean.
All students are welcome in my school.
Tests we take measure what has been taught.
The school recognizes students who improve and succeed academically.
My parents make sure that I complete homework and classwork.

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* 10. Please rate the following statements on a scale from strongly agree to strongly disagree.

  Strongly Agree Agree Neutral Disagree Strongly Disagree
The teachers, counselor, and principal recognize students for their learning and progress. 
I understand my teacher's lessons.
My teachers teach me to use problem-solving skills in my classwork and homework.
This school provides many ways for all students to learn.
My teachers frequently check to make sure that all students are learning.
This school has expectations for all students.
My parents know the programs available at school to support my learning.
My teachers encourage all students to participate in classroom discussions.
In my classroom, students who bully other students are disciplined.  

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