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School Climate Questionaire
2015-16 School Year
I am a...
What is your grade level?
Who is your teacher?
Your answer
This is how I feel about Green-Fields
Most of the time, this is how I feel about coming to school in the morning:
This is how much I like the children in this class:
In this class, I feel happy:
In this class, I feel interested
In this class, I feel sad
In this class, I feel bored
In this class, I feel angry
In this class, I feel lonely
The students in this class like me
The students in this class respect me
The children in this class like each other
The students in this class respect each other
The adults in this building care about me
There is a at least one adult at school that I can go to for help if something is bothering me.
Please give the name of an adult that you can go to for help if something is bothering you. If you are not sure then write"not sure". If you do not feel comfortable with any adults at school write "none".
Your answer
How often does another child in your class say something nice to you?
How often does another child in your class says something mean to you?
How often does another child in your class tease you?
How often does another child from your class exclude you or leave you out?
How often do you say something nice to someone in your class
How often do you say something mean to someone in your class?
How often do you tease someone in your class?
How often do you exclude someone or leave someone out in your class?
How often is another child mean to you on the bus
How often is another child mean to you at recess
How often does another child tell you that you can't play with them at recess.
This is how safe I feel on the playground
This is how safe I feel in the classroom
This is how safe I feel in the hallways of school
This is how safe I feel on the bus
This is how safe I feel in the cafeteria
Write the name of an adult at home you can talk to if you are having a problem
Your answer
List any ideas that you think would make you feel better about coming to school.
Your answer
As you are finishing this survey, check any feelings that you have now
Required
Do you have any suggestions for fun activities at school or privileges you would like to earn?
Your answer
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