Lincoln Student Personalization Survey 16-17
Dear Students,

We need your help to find out what you like about your school and how we can make it better. Please answer the questions below.

This is not a test. There are no right or wrong answers. We hope that you feel comfortable to answer the questions honestly and show how you really feel about our school. If you have a question or do not understand something, please raise your hand and quietly wait for your teacher's help.
I am a: *
What grade are you in? *
What school do you attend? *
This is how I feel about my school: *
Most of the time, this is the way I feel when I am coming to school in the morning: *
This is how much I like the children in my school *
I feel safe at school *
The teachers and other adults at my school are: *
I feel that if I have a problem at home or school, I feel that there is an adult at school with whom I can talk *
Students do not pick on, call names, or tease other students at this school *
How often does this happen to you in your classroom?
A lot
Sometimes
Never
Another Child in this class says something nice to me
Another child in this class says something mean to me
Another child in this class teases me
Another child in this class excludes me from activities
How often do you?
A lot
Sometimes
Never
Say something nice to someone in your class?
Say something mean to someone in your class?
Tease someone in your class?
Exclude someone in your class?
How often does this happen to you?
Never
Sometimes
A lot
Another child is mean to me during lunch
Another child teases me during lunch
Another child will not allow me to sit with hime or her during lunch
How often does this happen to you? *
Never
Sometimes
A lot
Another child is mean to me during recess?
Another child teases me during recess?
Another child will not play with me during recess?
I am excluded from groups during recess
As you are finishing this survey, how are you feeling right now?
Yes
No
Happy
Interested
Sad
Bored
Angry
Lonely
Feel free to share anything you would like adults at your school to know
Your answer
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