Student Behavior Survey
Student Name
First Name
Last Name
School Name
Grade Level
Thinking about your school, please rate the following statements.
Strongly Disagree
Somewhat Disagree
Somewhat Agree
Strongly Agree
1. Students treat each other with respect.
2. My teachers don't know about my life outside of the school.
3. I feel emotionally safe in my classes.
4. I feel emotionally safe outside of the classrooms.
5. Disciplinary rules in my school are fair.
6. Principals in my school are respectful to students.
7. All ethnicities are respected in my school.
8. Students care about good education in my school.
9. My teachers are good at teaching and communicating with students.
10. I feel that I am accepted and liked at my school.
11. I respect my teachers.
12. Most of my teachers know my name.
13. Students in my school are helpful.
14. Teachers at my school are respectful to each other and helpful.
15. I am physically safe outside of the classrooms.
16. Student can freely say what they think.
17. I am eager to learn.
18. I participate in classes.
19. I often need extra help with homework.
20. I cannot concentrate classes because of the problems outside of the school.
21. Have you ever skipped class or school?
Yes
No
22. Have your ever thought about dropping out of school?
Yes
No
Please check the reasons why you skipped classes or thought about leaving school.
Unprepared for class
Bullying or harassment of other students
I don't like my teachers.
Traveling to school is not safe.
I am bore at school.
I had family responsibilities
How often do your teachers talk to you about the following conditions?
Never
Once Or Twice
A Few Times A Year
Several Times A Year
23. Disrupting class.
24. Good academic performance.
25. Incomplete homework.
26. Poor academic performance.
27. Interests and things that matter to you.
28. Your future plans about college and career.
29. Your worries.
Please rate the following how much help you to learn.
Help A Lot
Help A Little
Not At All
30. More 1-1 attention from teachers
31. More real life examples
32. More challenging classes
33. More acceptance from other students
34. What skills do your favorite teachers have?
35. What are the most crucial issues that should be discussed in school?
Submit
Should be Empty: