Youth Outcomes Survey

Youth Outcome Survey

* Indicates required field

Name *

First

Last

These questions ask how you feel about yourself and other kids. For each sentence, decide how true the sentence is for you.

I am always doing things with a lot of kids. *

I wish that more people my age liked me. *

I find it hard to make friends. *

I would like to have a lot more friends. *

I am popular with others my age. *

I have a lot of friends. *

These questions ask how you feel about yourself, school, and your teacher(s).

I have trouble figuring out the answers in school. *

I feel that I am just as smart as other kids. *

I am very good at my school work. *

I'm pretty slow at finishing my school work. *

I often forget what I learn. *

I do very well at my class work. *

These questions are about your plans for high school and college.

How sure are you that you will finish high school? *

How sure are you that you will go to college? *

How sure are you that you will finish college? *

Thinking about grades you are getting in school, please select how you are doing.

Mathematics *

Reading or Language Arts *

Social Studies *

Science *

In these next questions thing about how you feel when other kids do certain things.

What do you think about kids your age using tobacco (cigarettes, cigars, smokeless or chewing tobacco)? *

What do you think about kids your age taking drugs that aren't given to them by a doctor or parent? *

What do you think about kids your age drinking alcohol without their parents knowing? *

What do you think about kids your age skipping school without permission? *

What do you think about kids your age hitting someone because they didn't like something they said or did? *

What do you think about kids your age breaking rules in school? *

What do you think about kids your age being late to school? *

These questions ask about how things are going with your parents or guardians. If you live with two parents, please think about the parent or guardian you feel closest to when you answer these questions.

How often do I feel that my parents respect my feelings? *

How often do I feel that my parents accept me as I am? *

How often do I feel that when I'am angry about something, my parents try to be understanding? *

These questions ask about some behaviors you might have engaged in over the past 30 days. Please remember that ALL of your answers will be kept private.

How often in the past 30 days have you been absent from school? *

How often, in the past 30 days, have you been late for school? *

A special adult is someone who does a lot of good things for you. For example someone (a) who you look up to and who encourages you to do your best, (b) who really cares about what happens to you, (c) who influences what you do and the choices you make, and (d) who you can talk to about personal problems.

Right now in your life, is there a special adult (NOT your parent or guardian) who you often spend time with? *

No, I don't have a special adult in my life right now. Yes, I do have a special adult in my life.

This question asks about some behaviors you might have engaged in over the past 12 months (year). Please remember that ALL of your answers will be kept private.

In the last 12 months, have you been arrested for a crime, offense, and/or a violation? *

Submit