Adolescent Lives in Transition: How Social Class Influences the Adjustment to Middle School

Appendix 4. Sample Student Questionnaire

275 A P P E N D I X 4 Sample Student Questionnaire Home, School, and Friends A Youth Questionnaire About Belonging, Hoping, and Caring Seventh Grade ~ Fall 1999 Dear_____________, Now that you have gone from grade 6 to grade 7, I would like to hear your first impressions of the Middle School. So, this is a questionnaire about you as a seventh grader. Your answers to these questions will help me to know how seventh grade meets (or doesn’t meet) your expectations, what activities you like to do, who you like to be with, what responsibilities you have, what you think about certain things, and who you go to when you need help. Some of the questions are the same as last time, but your answers may have changed. Some questions are different. Please take all the time you need and answer the questions carefully and honestly. Don’t worry about spelling but do your best. If you have any questions, please ask me. These are your answers; there are no right or wrong answers to these questions. If there is something more you want to tell me about your answer , or if these questions make you think of other things that I did not ask, we will have a chance to talk after. Thank you! Donna Name:__________________________________Age:______Date:________ Team:___________________________________Advisory:______________ Please list other schools you have been to since kindergarten and the grades you were there: If your address or phone number has changed since last time we met, please give your new.... Address:______________________________________________________ Phone:________________ Part I ~ Sentence Completion 1. When I thought about seventh grade, I expected to be... and now that I am in seventh grade, I am... 2. When I thought about seventh grade, I expected to feel... and now that I am in seventh grade, I feel... 3. When I thought about seventh grade, I expected to have... and now that I am in seventh grade, I have... 4. This year, I hope... 5. At home I feel... and at school I feel... 6. At home I act... and at school I act... 7. One thing I wish people at school could know about me is... 8. Now, I go to school with students from six towns and I have discovered . . . 9. Hillside... 10. Lakeview... 276 Appendix 4 Part II ~ Belonging and Participating 1. Please write down all the organized school activities, sports, and clubs you are or have been active in this year so far. Tell how many times a week you do this activity. Do not count the activities that you did in the sixth grade. School Activity: How many times per week? 2. Please write down all the organized community activities, sports, and clubs you are or have been active in this year. Tell how often you do them and tell what organization sponsors this activity (e.g., town rec. program, church, business). Include organized activities you did this past summer. Community Activity: Times/wk. Sponsor: 3. If you are active in sports or clubs, what is it about these activities in general that you enjoy? 4. If you are not active in sports or clubs, please tell the reasons why you do not participate. 5. If you do not like sports and clubs, please explain what you do not like. 6. Have you ever been a leader in school or in the community? ___Yes ___No If yes, in what way have you been a leader? For how long? 7. What time do you get up on school mornings? Do you: Take the bus?_______Get a ride?_______Walk to school?_______ 8. Please answer all the questions that apply to you: What time does the school bus pick you up? How far do you walk to get the bus? If you get a ride, who takes you? If you walk to school, how far do you walk? What time do you get to school? If you take late bus, what time do you get all the way home? Where does late bus drop you off? 9. In which class (subject) at school do you participate the most? 10. What or who encourages you to participate a lot? 11. In which class (subject) do you participate the least? 12. What or who discourages you from participating? Sample Student Questionnaire 277 Part III ~ Interacting with Friends, Classmates, Teachers, and Communities 1. Please think of all...