2018-2019 Camp Ernst Student Needs Assessment
Thank you for filling out this survey. This survey helps our school counselors and youth service center coordinator know what you need to be successful here at school. It is anonymous, meaning you DON'T have to put your name on it. If you want more information on any of these topics, you may contact your counselors or youth service center coordinator

Please take a moment to think about school. Think about how you are at school: how you act, feel, think while you are here, then answer the following questions.

What grade are you?
What gender are you?
I need help coping with stress.
I have trouble controlling my anger.
I get one or more Fs on a report card.
I'm worried about other students using drugs or alcohol
My parents are divorced or separated and that bothers me.
Bullying at school is a concern for me.
I've lost a close friendship recently.
I want to learn about different careers.
My family can't afford to buy me school supplies, clothes, or things I need.
I worry about a family member drinking alcohol too much or doing drugs.
I want to learn about college opportunities
I've thought about or talked about suicide.
I feel sad or depressed a lot.
I need help managing my time and keeping things organized.
I'm afraid to make a mistake.
I've skipped school.
I get really nervous and anxious before I take a test.
I need help learning how to study.
I need help learning how to get along with teachers.
I deal with abusive situations at home.
I feel neglected by adults in my life.
I have a hard time paying attention in class or on school work.
I worry about becoming homeless or I have been homeless before.
I'm concerned about rumors and gossip.
I'm worried about the health of a family member.
I feel bad about myself
I have a hard time making friends or getting along with other students.
I'm dealing with the death of a love one.
I'm hurting or cutting myself or I've done it in the past.
I'm having a hard time adjusting to a new school.
I have a hard time setting goals and working toward them.
If I am feeling sad or depressed, I have a trusted adult at school I could go to for help.
If I am feeling sad or depressed, I have a close friend I could talk to for support.
I want to learn more about after-school activities or summer programs/camps.
On average, what is the latest time you use your cell phone at night?
On average, how many hours do you spend talking to your friends or others on your cell phone each day? (call/text/apps)
On average, how many hours do you spend playing games, on the internet, or on social media apps on your cell phone each day?
Thank you for completing this survey. If you have any questions about anything on this form, please see your counselor or youth service center coordinator. We are here to help you in any way that we can.
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