Pre-Survey 2019/2020 | Crowdsignal.com

Pre-Survey (2019/2020 School Year)

Name Code: (First 2 Letters of Your First Name, First 2 Letters of Your Last Name, Day you were born) *

What is Your Teachers Name?

Title

First Name

Last Name

School Name: *

So far, what is your favourite part of grade six?

Sometimes, everyone worries about something. Can you tell us a little about what worries you?

	I worry a lot	I sometimes worry	I never worry
Making friends
Being late for school
Getting good grades
Being bullied
Being offered drugs
Being involved in a gang
Staying safe online
Having good relationships with people who are important to me
Going to junior high next year
Not fitting in
Staying fit and healthy
Getting enough to eat
Having a place to live

Making friends

I worry a lot I sometimes worry I never worry

Being late for school

I worry a lot I sometimes worry I never worry

Getting good grades

I worry a lot I sometimes worry I never worry

Being bullied

I worry a lot I sometimes worry I never worry

Being offered drugs

I worry a lot I sometimes worry I never worry

Being involved in a gang

I worry a lot I sometimes worry I never worry

Staying safe online

I worry a lot I sometimes worry I never worry

Having good relationships with people who are important to me

I worry a lot I sometimes worry I never worry

Going to junior high next year

I worry a lot I sometimes worry I never worry

Not fitting in

I worry a lot I sometimes worry I never worry

Staying fit and healthy

I worry a lot I sometimes worry I never worry

Getting enough to eat

I worry a lot I sometimes worry I never worry

Having a place to live

I worry a lot I sometimes worry I never worry

When online, what sites or apps do you use most? (where you spend the most time ... gaming, talking to friends, streaming etc.)