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Middle School Climate Survey
Please choose the school you attend.
Please indicate your grade.
Please indicate your race. (Choose a minimum of one or as many as apply.)
Are you Hispanic/Latino?
Please indicate your gender.
The first questions ask about your experiences at school, how you are treated, what you like and what you don't like. There are no right or wrong answers. Give us your impression concerning these statements about your school this year. Your opinions are important and will be used to help design programs and services for your school. We need your ideas and feedback to do this. Thank you for your help.
Please mark these statements about your school accordingly.
1. I regularly participate in extra-curricular activities offered through this school such as school clubs or organizations, musical groups, sports teams, student governments, dances, sporting events or any other extra-curricular activities.
2. People of different cultural backgrounds, races or ethnicities get along well at this school.
Students at this school are teased or picked on about...
Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
3 ...their race or ethnicity.
4 ...their cultural background or religion.
5 ...their physical or mental disability.
6 ...their perceived sexual orientation.
Students at my school...
Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
7...carry guns or knives to school.
8 ...belong to gangs.
9 ...threaten to hurt other students.
10 ...steal money, electronics, or other valuable things while at school.
11 ...damage or destroy other students' property.
12 ...damage or destroy school property.
13 ...fight a lot.
14 ...are sometimes physically hurt by their boyfriends or girlfriends while at school.
During this school year, how many times has someone from your school...
Almost every day
Once or twice a week
Once or twice a month
Once or twice this school year
Never
15 ...made fun of you, called you names or insulted you?
16 ...spread rumors about you?
17 ...threatened you with harm?
18 ...pushed you, shoved you, tripped you or spit on you?
19 ...tried to make you do things you did not want to do, for example, give them money?
20 ...excluded you from activities on purpose?
21 ...destroyed your property on purpose?
22 ...posted hurtful information about you on the Internet, threatened or insulted you online (direct messaging, text messaging, online gaming, instagram, snapchat, etc.)?
23 ...bullied you in any way?
I think that...
Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
24 ...if another person was bullying me, I would report it to an adult at this school.
25 ...if I told an adult at this school that I was being bullied, the adult would do something to help.
26. Have you told anyone that you have been bullied during this school year?
27. How often do the teachers or other adults at school try to put a stop to it when a student is being bullied at school?
28. Please click all the people you have told about being bullied this school year.
The next questions ask about your experiences with tobacco, alcohol and other drugs. There are no right or wrong answers. This information is confidential and cannot be traced back to you. Thank you for your help.
Please mark each question accordingly.
During the past 30 days...
Yes
No
29 ...did you drink one or more alcoholic beverages?
30 ...did you smoke part or all of a cigarette?
31 ...have you used marijuana?
32 ...have you used prescription drugs not prescribed to you or misused prescription drugs that were prescribed to you?
How much do you think people risk harming themselves physically or in other ways if they....
No Risk
Slight Risk
Moderate Risk
Great Risk
33 ...have 5 or more alcoholic beverages (beer, wine, liquor) once or twice a week?
34 ...have one or two alcoholic beverages (beer, wine, liquor) nearly every day?
35 ....smoke one or more packs of cigarettes per day?
36 ...smoke marijuana once or twice a week?
37 ...use prescription drugs that are not prescribed to them or misuse prescription drugs that were prescribed to them?
How wrong do your parents think it would be for you to...
Not at all Wrong
A Little Bit Wrong
Wrong
Very Wrong
38 ...have one or two alcoholic beverages nearly every day?
39 ...smoke tobacco?
40 ...smoke marijuana?
41 ...use prescription drugs not prescribed to you or misuse prescription drugs that were prescribed to you?
How wrong do your friends think it would be for you to...
Not at all Wrong
A Little Bit Wrong
Wrong
Very Wrong
42 ...have one or two alcoholic beverages nearly every day?
43 ...smoke tobacco?
44 ...smoke marijuana?
45 ...use prescription drugs not prescribed to you or misuse prescription drugs that were prescribed to you?
46. How do you USUALLY get alcohol if you consumed alcohol in the past 30 days?
47. How do you USUALLY get tobacco if you used tobacco in the past 30 days?
48. How do you USUALLY get prescription drugs (not prescribed to you) if you used prescription drugs (not prescribed to you) in the past 30 days?
The next questions ask about your knowledge and future plans. There are no right or wrong answers. Give us your thoughts about these statements. Your opinions are important and will be used to help design programs and services for your school. We need your ideas and experiences to do this. Thank you for your help.
Please mark each question accordingly.
49. I know what to do if there is an emergency, natural disaster (ex. tornado, flood) or a dangerous situation (ex. violent person on campus) during the school day.
50. If I hear about a threat to school or student safety, I would report it to someone in authority.
I think that...
Strongly Agree
Agree
Neither Agree Nor Disagree
Disagree
Strongly Disagree
51 ...I will definitely graduate from high school.
52 ...I plan to continue my education after high school.
53. I am happy to be at this school.
Please tell us if there is anything else about your school experience that you would like to share with us. Please enter your response in the space provided.
Your answer
Thank you for your time and help in improving your school!
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