INSTRUCTIONS

Please read each question and select the circle under the ONE answer that most closely fits your opinion. Be sure to answer every question. We appreciate you taking the time to do the survey.

There are NO wrong answers.

* 1. What grade are you in?

* 2. Please select the circle No, Sometimes, or Yes for each statement below.

  No Sometimes Yes
a. My school is kept clean.
b. I like my school building.
c. I feel safe around the outside of my school.
d. I feel safe in the hallways and bathrooms of the school.
e. I feel safe in my classroom.
f. Students at my school help each other when needed.
g. Students at my school are well behaved.
h. Most students in my school try to talk to other students if they are having a problem with them.
i Most students come to class prepared.
j. Most students in my school try to do their best.
k. Most students in my school treat each other well.

* 3. Please select the circle No, Sometimes, or Yes for each statement below.

  No Sometimes Yes
a. My teachers notice if I have trouble learning something.
b. I am bored in school.
c. My teacher listens to me.
d. My teachers would give me help if I needed it.
e. The homework I get from my teachers helps me learn.
f. My teachers give me work that is interesting.
g. Teachers and other adults here listen to students' ideas about the school.
h. My family wants me to do well in school.
i. My parents ask if I've gotton my homework done.
j. I want to explore and learn new things.
k. My teachers make learning interesting.
l. My teachers are proud when I do well.

* 4. Please select the circle No, Sometimes, or Yes for each statement below.

  No Sometimes Yes
a. My teachers want students to talk with other students about things that we are studying.
b . Students at this school are bullied.
c. Most students in my school get mad when they disagree with people.
d. Adults who work in my school treat students with respect.
e. My teachers really care about me.
f. Students at this school are teased, picked on, made fun of or called names.
g. My teachers help me do better on my schoolwork.
h. Most students in my school treat each other with respect.
i. My teachers treat some students better than others.
j. I feel like I'm part of this school.
k. I actively participate in class.
l. I like school.
m. I wish I went to a different school.
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