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Central High School Needs Assessment Survey
Teacher Form - Spring 2016
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* Indicates required question
Name
Your answer
Gender
*
Male
Female
Prefer not to say
Select all grades that you teach.
*
9
10
11
12
Required
Select the grade that you teach most frequently.
*
9
10
11
12
I teach an equal mix of two or more grades
Please rate each of the following items based on how important they are to you as a teacher and how important you feel they are for your student's success.
1= least important and 5 = most important.
Academic Concerns
College Applications
*
Least Important
1
2
3
4
5
Most Important
College Selection
*
Least Important
1
2
3
4
5
Most Important
Decision Making Skills
*
Least Important
1
2
3
4
5
Most Important
Learning Styles (audio/visual/hands-on)
*
Least Important
1
2
3
4
5
Most Important
Organizational Skills
*
Least Important
1
2
3
4
5
Most Important
Peer Mentoring/Community Service
*
Least Important
1
2
3
4
5
Most Important
Study Skills
*
Least Important
1
2
3
4
5
Most Important
Test Taking Skills
*
Least Important
1
2
3
4
5
Most Important
Time Management
*
Least Important
1
2
3
4
5
Most Important
Career Concerns
Career Interest Surveys
*
Least Important
1
2
3
4
5
Most Important
Career Research
*
Least Important
1
2
3
4
5
Most Important
Goal Setting
*
Least Important
1
2
3
4
5
Most Important
Job Applications/Interviewing Skills
*
Least Important
1
2
3
4
5
Most Important
Military
*
Least Important
1
2
3
4
5
Most Important
Vocational/Technical Schools
*
Least Important
1
2
3
4
5
Most Important
Personal/Social Concerns
Anger Management
*
Least Important
1
2
3
4
5
Most Important
Bullying/Harassment/Peer Pressure
*
Least Important
1
2
3
4
5
Most Important
Children of Divorce
*
Least Important
1
2
3
4
5
Most Important
Grief Management
*
Least Important
1
2
3
4
5
Most Important
Conflict Resolution
*
Least Important
1
2
3
4
5
Most Important
Listening Skills
*
Least Important
1
2
3
4
5
Most Important
Motivation
*
Least Important
1
2
3
4
5
Most Important
Self-esteem/Self Confidence
*
Least Important
1
2
3
4
5
Most Important
Social Skills (friends/relationship building)
*
Least Important
1
2
3
4
5
Most Important
Stress Management
*
Least Important
1
2
3
4
5
Most Important
Alcohol/Drug Abuse
*
Least Important
1
2
3
4
5
Most Important
Other Concerns (if any)
Your answer
If you have any other information that you would like to share with a counselor, please share below.
Your answer
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