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Student Engagement, Motivation, & Beliefs Survey

V2.0 ENGLISH VERSION

Marking Instructions: You may use pen or pencil.


Please completely fill-in the bubble for your response.

This survey is confidential and anonymous.

Read each of the following statements and decide how much you agree or disagree with them.
Strongly
Disagree
Disagree

I work hard at school


It's important to me that I improve my skills this year
I concentrate on my schoolwork
I feel proud of my school
I am a responsible student
I am treated with as much respect as other students
I complete my schoolwork regularly
In my school, I feel that I belong to a group of friends
I take responsibility for working on my goals
There's at least one adult in this school I can talk to if I have a problem
I am good at staying focused on my goals
I am comfortable asking my teacher(s) for help
I know I will graduate from high school
I have a clear sense of my ethnic background
I have a plan for what I want to do after high school
I feel good about my cultural or ethnic background
I am hopeful about my future
I respect other points of view, even when I disagree
I pay attention to how I feel
I work well in a group or team
I can resist doing something when I know I shouldn't do it
It is easy for me to communicate my thoughts and ideas
I can calm myself down when I am excited or upset
I can discuss a problem with a friend without making it worse
I am a hard worker
I feel bad when someone gets their feelings hurt
I finish whatever I begin
I am comfortable interacting with people from a different racial or ethnic
background
I am diligent (hard working and careful)
I can come up with new ideas
Setbacks don't discourage me
I like to imagine new ways to do things
I can do almost all the work in class if I don't give up

Neutral

Agree

Strongly
Agree

Strongly
Disagree
Disagree

Neutral

Agree

Strongly
Agree

I can learn the things taught in school

When my solution to a problem is not working, I try to figure out what


went wrong

What we do in school will help me succeed in life

I am a creative person

I try to think of many solutions when I have a problem


How smart I am is something that I can change
I am good at figuring out the best solution to problems I'm facing
One of my goals in class is to learn as much as I can
I solve problems by first breaking them into smaller steps
I try things even if I might fail

Please give use a little information about yourself. Remember that all information is confidential and your
responses will not be shared with anyone at your school or district.

Thank you for your time.


What is your
gender?

Within the last month, how often


were you absent from school?

female
male
other

Never

mostly A's,

mostly 1's,

mostly B's,

mostly 2's,

mostly C's,

mostly 3's,

mostly D's

mostly 4's

mostly E/F's

How often is English spoken in


your home?

Always
Most of the time
Sometimes
Rarely or never

1 day
2 - 4 days
5 or more days

What were your grades like last


year? (select one answer)

What is your race / ethnic origin?


American Indian/Alaskan Native

4th

Asian

5th

Pacific Islander/Native Hawaiian

6th

Black/African American

7th

Hispanic/Latino of any race

8th

White

9th

Two or more Races

10th
11th

Do you receive services for:

12th

ELL?

Name of your school?

Special Education?

What are you most likely to do


after you finish high school?

attend a four-year college


attend a community college
attend a vocational school
work full-time
join the military
other

don't know

What grade are


you in?

How often do you participate in


organized activities outside of school
(sports, arts or music, community
service, after-school programs,
religious or cultural activities, etc.)?

YOUTH
DEVELOPMENT EXECUTIVES
OF KING COUNTY

Not at all
A few times a year
Once or twice a month
Once or twice a week
Three or more times a week