* 1. Are you male or female?

* 2. What grade are you in?

* 3. On average what grades do you make?

* 4. During the school year, from which of the following school sources have you received any information about drugs, alcohol, or violence?  (Mark all that apply)

* 5. How safe do you feel when you are at school?

* 6. During the school year, how often have you or your close friends been physically harmed or threatened with physical harm by another student at your school?

* 7. During this school year, have you physically harmed or threatened another student at school?

* 8. During this school year, how often have you or your close friends been made fun of, talked about, or picked on by another student at your school?

* 9. Are school rules on drugs, alcohol, and tobacco use enforced by school staff?

* 10. Are rules on verbal or physical assaults, or fighting enforced by school staff?

* 11. My own experience with any tobacco, alcohol, or drugs is?

* 12. During this school year, have you had difficulties with any of your friends because of your use of tobacco, alcohol, or drugs?

* 13. During this school year, have you been in trouble with the police because of tobacco, drugs, or alcohol?

* 14. If you had a drug or alcohol problem and needed help, who would you go to?

* 15. How dangerous do you think it is for kids your age to use tobacco products?

* 16. How dangerous do you think it is for kids your age to use alcohol?

* 17. How dangerous do you think it is for kids your age to use drugs that could stimulate or sedate you?

* 18. Has a friend's use of alcohol, tobacco, or drugs ever caused problems between you and your friend?

* 19. During this school year, which of the following items have you brought to school?  (Mark all that apply)

* 20. Do any of your friends belong to a gang?

* 21. How do your parents feel about someone your age using alcohol?

* 22. How do your parents feel about someone your age using tobacco?

* 23. How do your parents feel about someone your age using any type of drug that might stimulate or sedate?

* 24. Do you follow school and classroom rules?

* 25. Do you feel that the teachers, assistant principal, and principal handle the school discipline fairly?

* 26. Do you feel that the teachers respect you regardless of your grades, involvement in sports, popularity, and family income?

* 27. Are you given enough leadership opportunities?

* 28. Do you treat your teachers with respect?

* 29. Do you feel that you have equal opportunities to actively participate in classroom activities?

* 30. Do you have fun at school?

* 31. Do you feel that homework is necessary for your education?

* 32. Do you feel the teachers expect enough of you in the classroom?

* 33. Do your teachers praise you enough?

* 34. Do you feel your teachers expect you to succeed in life?

* 35. If you need extra help are your teachers there for you?

* 36. Do your teachers encourage your success rather than point out your failures?

* 37. Do your parents oversee and stress the importance of your homework?

* 38. Are there times when your teacher is stopped from teaching during class?

* 39. Is your work and other student work checked or graded regularly?

* 40. When you are given seat work, do teachers watch you and other students closely?

* 41. Do your teachers communicate often with your parents telling them about what you do well and areas that you need to strengthen and improve?

* 42. Please give any suggestions you would like to about making Covington ISD a safe and drug free campus.

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