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High School Needs Assessment Sample

Please read the statements below and circle Yes or No as it applies to you.

1.                  I feel good about myself most of the time.                               YES       NO

2.                  It is hard for me to make friends.                                            YES       NO

3.                  In the last 30 days I have used drugs or alcohol.                     YES       NO

4.                  I would like more information about college.                           YES       NO

5.                  I trust a staff member at school if I have a problem.                 YES       NO

6.                  I give up on things before completing them.                             YES       NO

7.                  I would like to participate in a support group.                          YES      NO

8.                  I have an anger problem.                                                        YES       NO

9.                  I would like more information on jobs and careers.                  YES       NO

10.              I skip school at least once a week.                                          YES        NO

11.              I would like some assistance with my homework.                     YES       NO

12.              It is important for me to graduate.                                            YES       NO