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* 1. Please check the school you attend.

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* 2. Do you understand your classwork?

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* 3. Do you need more help with your homework?

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* 4. Do you do your best work and try hard at school?

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* 5. Do you feel safe at school?

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* 6. If you answered NO and do NOT feel safe at school, please explain why.

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* 7. Do you good friends at school?

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* 8. Are kids at school mean to you?

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* 9. Do you feel good about yourself?

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* 10. Do you wish you were healthier?

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* 11. Do you wish you looked different?

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* 12. Do you wish you got better grades in school?

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* 13. Would you stay after school for a club if one sounded fun?

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* 14. What type of club would you like to have after school?

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* 15. I know what my teachers expect when they ask me to read my assignments.

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* 16. I know where I can get help for improving my reading skills.

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* 17. I know at least one adult that can help me with my reading skills outside of school.

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* 18. Check the things you use at home. 

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* 19. Where are you most often when you use the internet?

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* 20. Do you have problems with people texting or sending you mean things?

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* 21. What do you like about your school. 

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* 22. Are you nervous about switching to a new school building?

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