Student PRE Self Assessment Form
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Student Name or Name/Surname Initials (eg. RC) * *
Grade/Year Level *
School / Agency Name *
PLEASE READ: From a scale of 1 to 5 (1 = a little / 5 = a lot), how would you rate your capacity to do the following:
I can name the different emotions I feel *
A little Bit
A lot
I can tell others about my personal qualities and achievements *
A little Bit
A lot
I am willing to learn new things *
A little Bit
A lot
I make things right when I know I’ve done the wrong thing *
A little Bit
A lot
I can express my emotions appropriately *
A little Bit
A lot
I am disciplined and achieve my goals *
A little Bit
A lot
I always try my best in the things I do *
A little Bit
A lot
I can work by myself and show initiative *
A little Bit
A lot
I am able to bounce back from difficult situations *
A little Bit
A lot
I can work through my problems and try to find a solution *
A little Bit
A lot
I am able to appreciate other peoples ideas and opinions *
A little Bit
A lot
I am connected to my classmates *
A little Bit
A lot
I try to help others when they have difficulties *
A little Bit
A lot
I am respectful and considerate to others *
A little Bit
A lot
I can make and keep friends *
A little Bit
A lot
I can communicate well with others *
A little Bit
A lot
I can communicate well with others *
A little Bit
A lot
I can make the right decisions when I am under pressure *
A little Bit
A lot
I can help others to resolve conflicts *
A little Bit
A lot
I can lead other people by showing them how to do things *
A little Bit
A lot
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This form was created inside of The MAT Program.