1. If we were going to start some new clubs or interest groups at our school, what would you suggest?
2. If you do not understand something the teacher has taught, how do you get help?
3. Name one learning area you think you have improved in and describe what has helped you improve.
4. We want to know how you think we can reduce bullying in our school. What things can we do, or do better?
5. If you were able to make a change or addition to the school’s “code of conduct”, what would it be?
Multiple Choice Questions
1. When you need help, what is the MOST useful to you?
- Teacher help at recess/lunch time
- Homework assistance after school
- Peer tutoring from another student
- Extra work to be done at home
2. What school did you attend before coming to ABC High School?
- Yellow Elementary School
- Green Elementary School
- Red Elementary School
- Blue Elementary School
3. How often are you hungry at school because there is not enough food at home for your breakfast or lunch?
- Once or twice a month
- Once or twice a week
- Every day
4. Do you have easy access to transportation to get to and from after-school activities?
- I do not participate in after-school activities
5. If you have participated in mediation with a peer or engaged in restorative actions, how effective was it in solving your problem?
- Very effective (the problem was resolved)
- Somewhat effective (the problem was not resolved, but is manageable)
- Not effective (the problem was not resolved and is not manageable)
- I did not participate in mediation with a peer and did not engage in restorative actions
Multiple Answer Questions
1. What subjects would you like to see included in our lunch-break tutoring program (select all that apply):
- Social Studies
2. What clubs would you like started at 123 Public School (select all that apply):
- Lego Club
- Robotics Club
- Drawing Club
- Peer Mentoring Club
- Reading Club
3. Which of the following school fundraising activities would you be interested in seeing during the upcoming school year (select all that apply)?
- Plant sale
- Car wash
- Tupperware sale
- Recycling for cash
- Family photo day
- None of the above
4. Select any of the following items you would like to see added to the cafeteria’s lunch combo menu:
- More salad options (ex. caesar or greek salad)
- Fresh fruit (ex. an apple or banana)
- Vegetables and dip
- Hummus and crackers
- None of the above
5. If you have been absent from school in the past month, please indicate any of the following reasons why you missed class:
- I had a medical appointment (ex. doctor or dentist appointment)
- I was sick
- I attended an extracurricular activity (ex. soccer game or mathletes competition)
- I was on a family vacation
- I was in detention
- I missed the school bus and could not get a ride to school
- I prefer not to say
- I have not been absent from school in the past month