Family PBIS School Climate Survey
Please answer all of the questions. You can mark "I prefer not to answer" if you don't want to answer a question about you.
Demographics
Section 1 of 6
Please indicate the grade of your student or students. (mark all that apply)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
I prefer not to answer
Is your student enrolled in any of these programs? (mark all that apply)
Special Education Program or has an Individualized Education Program (IEP)
Gifted Program or Honors/Advanced Placement Courses
Not applicable, not sure, I prefer not to answer
What is your gender identity?
Female
Male
Non-binary, transgender or other
I prefer not to answer
Clear selection
What is your ethnicity?
Hispanic or Latino/a
Not Hispanic or Latino/a
I prefer not to answer
Clear selection
What is your race? (mark all that apply)
American Indian or Alaskan Native
Asian
Black or African American
Native Hawaiian or Pacific Islander
White
I prefer not to answer
Beyond that, is there another ethnic group with which you identify? (if you prefer not to answer, then write " I prefer not to answer")
Your answer
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