This survey asks for your views about different qualities of your school. It will take you about 5-10 minutes to respond to the 30 statements. The survey uses a 5-point scale, with 1 meaning you “don’t agree at all” with the statement, and 5 meaning you “agree completely.” (Use the X when you don’t know or the statement does not apply.) Mark one number for each statement.
Please respond honestly to each statement. Your responses will be anonymous and remain confidential. Participation is voluntary – if you do not want to take the survey, check the box below and return the blank survey.
I choose
not to respond to this survey:
School District __________________________________ Date ________________
School Name _______________________________________________________________________

Use the following scale to guide your responses:
|
5 Agree Completely 4 Agree Mostly 3 Agree Moderately 2 Agree Slightly 1 Don’t Agree at All X Don’t Know/Does Not Apply |
Don’t Know/ |
Don’t agree at all |
Agree slightly |
Agree moderately |
Agree mostly |
Agree completely |
|
1. My school has specific goals that I understand. |
X |
1 |
2 |
3 |
4 |
5 |
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2. The main purpose of my school is to help students learn. |
X |
1 |
2 |
3 |
4 |
5 |
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3. Teachers make it clear what I am supposed to learn. |
X |
1 |
2 |
3 |
4 |
5 |
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4. I know why it is important for me to learn what is being taught. |
X |
1 |
2 |
3 |
4 |
5 |
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5. My classes challenge me to think and solve problems. |
X |
1 |
2 |
3 |
4 |
5 |
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6. Teachers expect all students to work hard. |
X |
1 |
2 |
3 |
4 |
5 |
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7. Teachers expect all students to succeed, no matter who they are. |
X |
1 |
2 |
3 |
4 |
5 |
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8. My classes are usually interesting. |
X |
1 |
2 |
3 |
4 |
5 |
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9. Teachers give me challenging work. |
X |
1 |
2 |
3 |
4 |
5 |
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10. My teachers make learning interesting by teaching in different ways. |
X |
1 |
2 |
3 |
4 |
5 |
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11. Students feel free to express their ideas and opinions. |
X |
1 |
2 |
3 |
4 |
5 |
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12. My teachers help me when I don’t understand something. |
X |
1 |
2 |
3 |
4 |
5 |
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13. Teachers give students extra help if it is needed. |
X |
1 |
2 |
3 |
4 |
5 |
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14. My teachers encourage me. |
X |
1 |
2 |
3 |
4 |
5 |
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15. Students are given many chances to show what we have learned. |
X |
1 |
2 |
3 |
4 |
5 |
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16. Tests and quizzes are related to the material and ideas we are supposed to learn. |
X |
1 |
2 |
3 |
4 |
5 |
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17.
|
X |
1 |
2 |
3 |
4 |
5 |
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18. Discipline problems are handled fairly. |
X |
1 |
2 |
3 |
4 |
5 |
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19. The adults in my school work well together. |
X |
1 |
2 |
3 |
4 |
5 |
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20. My teachers care about me as a person. |
X |
1 |
2 |
3 |
4 |
5 |
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21. The adults in my school show respect for me. |
X |
1 |
2 |
3 |
4 |
5 |
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22. Students respect those who are different from them. |
X |
1 |
2 |
3 |
4 |
5 |
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23. The teachers and other adults in my school show respect for each other. |
X |
1 |
2 |
3 |
4 |
5 |
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24. I feel safe when I am at school. |
X |
1 |
2 |
3 |
4 |
5 |
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25. Students can participate in many different school activities (sports, clubs, etc). |
X |
1 |
2 |
3 |
4 |
5 |
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26. The school environment makes it easy to learn. |
X |
1 |
2 |
3 |
4 |
5 |
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27. I know how to get help from an adult at school if I need it. |
X |
1 |
2 |
3 |
4 |
5 |
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28. The adults who work at my school care about all students, not just a few. |
X |
1 |
2 |
3 |
4 |
5 |
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29. My teachers contact my family if I am having problems learning. |
X |
1 |
2 |
3 |
4 |
5 |
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30. Many parents and adults from the community come and help at the school. |
X |
1 |
2 |
3 |
4 |
5 |
Please answer several questions about yourself (check one for each question).
A. What grade are you in? #9th #10th #11th #12th #Ungraded #Not sure
B. What is your gender? #Male #Female
C. What is your primary race/ethnicity? #Amer. Indian/Native Amer. #African American/Black
#Asian/Pacific Islander #Hispanic/Latino
#White/Caucasian #Multi-racial #Other
D. What is your approximate grade point average (GPA)?
# Above 3.50 # 3.00-3.50 # 2.50-2.99 # 2.00-2.49
# 1.50-1.99 # 1.00-1.49 # Below 1.00 # Ungraded / Don’t Know
Comments or Response to Optional Question(s):