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					                                               School Survey

Name: ____________________________________
Age: ____________________________                       Gender: _________________________

                                1               2         3        4
                              Always      Sometimes     Often    Never

For each question below, circle the number to the right that best fits your opinion
on the importance of the issue. Use the scale above to match your opinion.

                                    Question                             Scale

1. I like school.                                                      1 2 3     4

2. Teachers treat me with respect.                                     1 2 3     4

3. I am important.                                                     1 2 3     4

4. My classmates are nice to me.                                       1 2 3     4

5. My school looks good.                                               1 2 3     4

6. I share what happens at school with my parents.                     1 2 3     4

7. I know the rules for my school.                                     1 2 3     4

8. If I had a problem, I could talk to the principal.                  1 2 3     4

9. I am proud of my school.                                            1 2 3     4

10. Teachers care about me.                                            1 2 3     4

11. I can succeed at school.                                           1 2 3     4

12. I have lots of friends.                                            1 2 3     4

13. My classroom is comfortable.                                       1 2 3     4

14. My parents care about my homework.                                 1 2 3     4

15. I know the rules in my classroom.                                  1 2 3     4

16. The principal cares about me.                                      1 2 3     4

17. My school is a neat place to be.                                   1 2 3     4

18. Teachers treat everyone fairly.                                    1 2 3     4

19. I have a future.                                                   1 2 3     4

20. I am an important part of my class.                                1 2 3     4
                                              School Survey

                                                  Part 2

                               1              2             3        4
                             Always     Sometimes          Often   Never

For each question below, circle the number to the right that best fits your opinion
on the importance of the issue. Use the scale above to match your opinion.

                                   Question                                Scale
21. I feel safe at school.                                               1 2 3     4
22. My parents care about me.                                            1 2 3     4
23. The rules in my classroom are fair.                                  1 2 3     4
24. If I get into trouble, the principal will treat me fairly.           1 2 3     4
25. School is fun.                                                       1 2 3     4
26. Teachers explain the work so that I can understand it.               1 2 3     4
27. I have control of my grades.                                         1 2 3     4
28. Other students pick on me.                                           1 2 3     4
29. My school is clean and neat.                                         1 2 3     4
30. My parents think this is a good school.                              1 2 3     4
31. When something happens, I get blamed.                                1 2 3     4
32. The principal does a good job.                                       1 2 3     4
33. I think good grades are important.                                   1 2 3     4
34. My teacher tells me when I am doing a good job.                      1 2 3     4
35. I am proud of my school work.                                        1 2 3     4
36. Other students follow my ideas.                                      1 2 3     4
37. My school has up-to-date equipment.                                  1 2 3     4
38. My parents are involved at school.                                   1 2 3     4
39. Punishment for not following the rules are fair.                     1 2 3     4
40. The principal cares what's going on in my classroom.                 1 2 3     4

				
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