Student Courage Survey Form

Student Courage Survey Form
Reflect on and report your experiences with courage in school or student-life situations. Please answer all questions honestly. There are no right or wrong answers.
How often do you feel you act courageously at school?
Rate your agreement: I am willing to stand up for what is right, even if I am the only one.

1
2
3
4
5
1 is Strongly Disagree, 5 is Strongly Agree
In which situations do you find it most challenging to show courage?
Other
How likely are you to help a classmate being treated unfairly?

1
2
3
4
5
1 is Very Unlikely, 5 is Very Likely
When you witness someone else being courageous, how does it influence you?
Other
How comfortable are you with admitting mistakes in front of others?

1
2
3
4
5
1 is Not Comfortable, 5 is Very Comfortable
Rate your agreement: I would speak up if I saw someone being bullied.

1
2
3
4
5
1 is Strongly Disagree, 5 is Strongly Agree
How often do you encourage others to be courageous?
For each scenario, indicate how likely you are to act courageously.
Rows Very Unlikely Unlikely Neutral Likely Very Likely
Standing up for a friend
Reporting a rule violation
Admitting a mistake publicly
Describe a time when you showed courage in a school or student-life situation.
Should be Empty:

Select theme:

Rows	Very Unlikely	Unlikely	Neutral	Likely	Very Likely
Standing up for a friend
Reporting a rule violation
Admitting a mistake publicly