Student Description Survey (Grades 3-5)
Please complete the following survey about yourself. This information will be used to describe the students who participate in this project. Your response to individual items is optional and your name will never be reported in any description of the program
Student First and Last Name *
Name of School *
Teacher *
Age *
Grade Level *
Required
Gender (check) *
Required
Please check one of the following *
Required
Read each sentence carefully and check the answer that is most like you. *
Almost Always Like Me
Somewhat Like Me
Not Much Like Me
Not at all like me
I try to share what I have when somebody needs something.
When I am angry with someone, I know how to calm down
I try to tell the truth even when it is hard.
I let people know that I appreciate their help
I try to help when someone is in need
I do kind things for others, even when I don't get any reward
When someone says something mean to me, I know how to stop being upset
When no one is watching, I still try to do the right thing.
When I forgive someone I feel better.
I try to do my best even when something is hard to do.
I am thankful for the friends I have.
When somebody hurts my feelings, I can still get along with them.
When things aren't going well, I try to find something to be grateful for.
I keep trying even when something is difficult for me.
I try to understand how someone else feels.
I try to make good choices, even when others don't
When someone is mean to me, I try to get back at that person.
I feel sad when someone else is upset
When someone hurts my feelings, I try to let it go.
I think there are many things to be thankful for.
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