Boys & Girls Clubs Big Brothers Big Sisters of Edmonton & Area

There are no right or wrong answers. Please answer all of the questions as truthfully and completely as you can. Everything you tell us will be kept private. Your answers will not be shared with your parents or your guardians or your teachers. We are only interested in what youth as a group tell us and not your individual answers. For each question, decide how tru the sentence is for you, then choose the answer that fits best.

* 1. Date Survey Completed

* 2. First Name:

* 3. Last Name

* 4. Gender

* 5. Grade

* 6. School

* 7. Number of years being mentored

* 8. Chose the answer that fits best

  Strongly Agree Agree Undecided Disagree Strongly Disagree
I am doing my best at school
I enjoy my class work
I am able to talk to my classmates easily
I can solve the arguements I get into with others
I feel comfortable joining a new activity or group
I feel comfortable learning from my mistakes
I feel good about myself when I am at school
I feel good about my ability to solve problems
School is important for achieving my future goals
I enjoy being at school
Thinking about community and school resources, I can find help if I need it
I am involved in school programs
I am involved in programs outside of school (e.g., sports, clubs)
I feel like I belong at school
I have an adult in my life that I can talk to about almost anything
I feel supported by adults around me
I have good friends who care about me
I am a good role model
I tell the truth even when it's hard
I feel comfortable disagreeing with my friends if I think they are wrong
I use good manners
I listen and treat my classmates with respect
I have friends from different cultural backgrounds
I like doing things for others
I think that we should help other people
I look out for others who are being left out or ignored

* 9. Please rate how good you feel about your ability to:

  Very Good Good Okay Poor
Solving problems
Make decisions
Ask for help when you need it
Do your school work
Help out when I am needed
Talk to other students
Talk to adults
Be positive

* 10. Why did you want to be mentored?

* 11. What do you most look forward to in being mentored?

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