Needs Assessment 17-18
Please be aware that this survey is ANONYMOUS. Some questions may bring up some difficult feelings. If so, we encourage you to make an appointment with your grade level counselor (Ms. Ballweg, Mrs. Jelinek, or Mrs. Leigh) Social Worker (Mr. Olsen) or the Social Emotional Learning Specialist (Mr. Irwin). Please answer each question on this survey. Thank you!
I __________feel attacked or bullied on social media (Snapchat, Instagram, Facebook, Text, etc. ) *
I __________attack or bully others on internet/social media (Snapchat, Instagram, Facebook, Text, etc.) *
Someone has bullied or harassed me at Bell Middle School during this school year. *
Choose one
When I see a student being bullied I know what to do. *
When I see a student being bullied at Bell, I will be an up stander ( I will either help that student or report what I saw to an adult). *
I know how to resolve conflicts with my peers. *
If I see someone crying or upset I typically: *
I treat people who are different from me fairly and equally. *
I would say I have a good relationship with my parents/guardians *
I am experiencing negative peer pressure (such as pressure to use drugs, alcohol etc.) *
I have used alcohol before. *
I have used drugs before. *
I am in a friendship that may not be good for me. *
I am concerned about my current grades. *
I plan to check my grades on Campus Portal. *
Which Career Cluster are you interested in? (click on link to see detailed list of careers) *
I have a _________________ goal I am working on this year *
I feel safe and supported at Bell Middle School *
I am having a difficult time with... *
Check all that apply
If there is an adult at school you feel comfortable going to when you need help please write his or her name below. If there is not an adult you feel comfortable going to, please leave the space below blank.
Your answer
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