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* 1. What is your current gender identity?

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* 2. What is your race as you define it? Mark all that apply.

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* 3. Which term best describes your sexual orientation?

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* 4. What is your current status?

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* 5. What sex were you assigned at birth, meaning on your original birth certificate?

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* 6. I feel valued in the classroom/learning evnironment.

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* 7. Faculty, staff, and administrators respect what students on this campus think.

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* 8. I think faculty are genuinely concerned about my welfare.

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* 9. I think administrators are genuinely concerned about my welfare.

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* 10. I feel close to people on this campus.

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* 11. I feel like I am a part of this school.

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* 12. The faculty, staff, and administrators at this school treat students fairly.

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* 13. I feel safe on this campus.

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* 14. School officials (administrators, teachers, counselors, security) should do more to protect students from harm.

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* 15. If a crisis happened on campus, my school would handle it well.

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* 16. The school responds too slowly in difficult situations.

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* 17. School officials handle incidents in a fair and responsible manner.

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* 18. My school does enough to protect the safety of students.

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* 19. There is a good support system on campus for students going through difficult times.

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* 20. The school authority take reports of sexual assault very seriously.

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* 21. In order to respond properly, the school would keep knowledge of the report limited to those who need to know.

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* 22. The school would take steps to protect the person making the report from retaliation.

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* 23. The school would take steps to protect the safety of the person making the report.

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* 24. The school would forward the report outside the campus to criminal investigators.

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* 25. The school would take corrective action to address factors that may have led to the sexual assault.

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