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Exit Survey
 
 
Are you male or female? Mark one response
 
Male
 
Female
 
 
 
Are you of Hispanic or Latino origin? Mark one response.
 
Yes
 
No
 
 
 
What is your race? You may mark one or more races.
 
White
 
Black or African-American
 
Asian
 
American Indian or Alaska Native
 
Native Hawaiian or Pacific Islander
 
Other
 

 
 
 
Is your main assignment/responsibility at this school to provide instruction or other support services to any of these types of students - Special Education, English Language Learners, Gifted and Talented Education students, and Migrant Education? Mark one response
 
Yes
 
No
 
 
 
How many years have you been working at this school? Mark one response.
 
1-3 years
 
4-9 years
 
10-19 years
 
20 or more years
 
 
How strongly do you agree or disagree with the following statements about this school? Mark One Response
Strongly Agree Agree Disagree Strongly Disagree
At this school, all students are treated equally, regardless of whether their parents are rich or poor.
This school encourages students to take challenging classes no matter their race, ethnicity, nationality, and/or cultural background (e.g., honor level courses, gifted courses, AP or IB courses).
This school provides instructional materials (e.g., textbooks, handouts) that reflect students’ cultural background, ethnicity and identity.
This school emphasizes showing respect for all students’ cultural beliefs and practices.
This school provides effective resources and training for teaching students with Individualized Education Programs (IEPs) across different languages and cultures.
This school provides effective supports for students needing alternative modes of communication (e.g., manual signs, communication boards, computer-based devices, picture exchange systems, Braille).
Staff do a good job helping parents to support their children's learning at home.
Staff do a good job helping parents understand when their child needs to learn social, emotional, and character skills.
If a student has done something well or makes improvement, staff contact his/her parents.
This school asks families to volunteer at the school.
Strongly Agree Agree Disagree Strongly Disagree
This school communicates with parents in a timely and ongoing basis.
My level of involvement in decision making at this school is fine with me.
Staff at this school have many informal opportunities to influence what happens within the school.
At this school, students are given the opportunity to take part in decision making.
Administrators involve staff in decision-making.
This school provides students with opportunities to take a lead role in organizing programs and activities.
Students are encouraged to get involved in extra-curricular activities.
I feel like I belong.
I feel satisfied with the recognition I get for doing a good job.
I feel comfortable discussing feelings, worries, and frustrations with my supervisor.
 
 
How strongly do you agree or disagree with the following statements about this school? Mark One Response
Strongly Agree Agree Disagree Strongly Disagree
This school inspires me to do the very best at my job.
People at this school care about me as a person.
I can manage almost any student behavior problem.
I feel safe at this school.
The following types of problems occur at this school often: physical conflicts among students.
The following types of problems occur at this school often: robbery or theft.
The following types of problems occur at this school often: vandalism.
The following types of problems occur at this school often: student possession of weapons.
The following types of problems occur at this school often: physical abuse of teachers.
The following types of problems occur at this school often: student verbal abuse of teachers.
 
 
 
This question is about bullying. Bullying happens when one or more students tease, threaten, spread rumors about, hit, shove or hurt another student. It is not bullying when students of about the same strength or power argue or fight or tease each other in a friendly way. Bullies are usually stronger, or have more friends or more money, or some other power over the student being bullied. Usually, bullying happens over and over, or the student being bullied thinks it might happen over and over.

I think that bullying is a frequent problem at this school.
 
Strongly Agree
 
Agree
 
Disagree
 
Strongly Disagree
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
How satisfied are you with the following:
Very Dissatisfied Not Satisfied Neutral Satisfied Very Satisfied
Website
Customer Service
Overall