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Demo Survey

To better support you, your school and teachers would like to ask you some questions about how you think and feel. Only your teachers and school leaders will be able to see your responses, which will not affect your class grades. Please respond honestly—there are no right or wrong answers!

Your Behavior

Please answer the following questions about how you respond to different situations. During the past 30 days…

1.

How often did you come to class prepared?
2.

How often did you follow directions in class?
3.

How often did you get your work done right away, instead of waiting until the last minute?
4.

How often were you polite to adults?
5.

How often did you pay attention and resist distractions?
6.

When you were working independently, how often did you stay focused?
7.

How often did you remain calm, even when someone was bothering you or saying bad things?
8.

How often did you allow others to speak without interruption?
9.

How often were you polite to other students?
10.

How often did you keep your temper in check?

Feelings in General

In this section, we are hoping to learn how you experience different emotions that may occur in your life (whether inside or outside of school).

11.

When you are feeling pressured, how easily can you stay in control?
12.

How often are you able to pull yourself out of a bad mood?
13.

When everybody around you gets angry, how relaxed can you stay?
14.

How often are you able to control your emotions when you need to?
15.

Once you get upset, how often can you get yourself to relax?
16.

When things go wrong for you, how calm are you able to remain?

Your Feelings

These questions ask about how you’ve been feeling recently. Please respond honestly—there are no right or wrong answers because there are no right or wrong feelings! Your answers will help us better support you and other students, and will not affect your grades or show up on your report card. You can skip any question you don’t feel comfortable answering.

During the past week, how often did you feel _______?

17.

excited
18.

happy
19.

loved
20.

safe
21.

hopeful
22.

angry
23.

lonely
24.

sad
25.

worried
26.

frustrated
27.

Thinking about everything in your life right now, what makes you feel the happiest?

28.

Thinking about everything in your life right now, what feels the hardest for you?

29.

What can teachers or other adults at school do to better support you?