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* 1. What is your gender?

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* 2. What is your race? (Mark all that apply.)

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* 3. What grade are you in?

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* 4. Which school do you attend?

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* 5. I like school.

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* 6. I feel like I do well in school.

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* 7. My school wants me to do well.

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* 8. My school has clear rules for behavior.

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* 9. Teachers treat me with respect.

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* 10. Good behavior is noticed at my school.

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* 11. I get along with other students.

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* 12. I feel safe at school.

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* 13. Students treat each other well.

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* 14. There is an adult at my school who will help me if I need it.

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* 15. If you answered Always or Often to the above question, who is it that you trust at school to talk with if you need help?

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* 16. Students in my class behave so that teachers can teach.

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* 17. My class participates in community circles at least twice a week.

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* 18. I find the community circles meaningful.

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* 19. What do you like most about school?

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* 20. Is there anything about school that you do not like or is there something you would like your teacher or principal to know?

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