Student Survey 2023

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Student Survey 2023

Thank you so much for taking this survey! This information can help us to support you and your journey at JMS.

First Name *

Last Name *

Grade *

6th

7th

8th

Team

Courage (6th Grade)

Perseverance (6th Grade)

Responsibility (7th Grade)

Integrity (7th Grade)

Determination (8th Grade)

Excellence (8th Grade)

Clear selection

Do you have a hard time with any of the following? (Check ALL that apply to you.) *

fighting

feeling angry

feeling lonely (left out, no friends, etc.)

feeling unloved or unimportant

feeling that you have been put down, insulted or humiliated

worrying

being manipulated or hurt

manipulating others

feeling self-confident

feeling unhappy or depressed

lying, cheating, or stealing

headaches, stomach aches, sickness (I see the nurse a lot)

hurting yourself

feeling suicidal

drugs or alcohol

unhealthy behaviors (sexual behaviors, not getting enough to eat, not having clean clothes, sleeping)

Are you on probation or have you been arrested?

NONE OF THE ABOVE apply to me.

Required

There is at least one adult at SCHOOL I can go to if I need someone to talk to. *

Yes

There is at least one adult OUTSIDE of school I can go to if I need someone to talk to. *

Yes

Please choose one of the following... *

I live in a shelter - we do not have our own home at this time.

My family shares a home with another family (other friends or family members).

I live in a car, park, campground.

My family lives in a hotel or motel.

I live with my parents/guardians in our own home or apartment.

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