Little’s Annual Survey

Little's Annual Survey

PLEASE ENSURE THAT YOUR CHILD COMPLETES THIS SURVEY

Thank you for being part of the Big Brothers Big Sisters program. In order for us to continue serving you we need your feedback! This survey should take about 15-20 minutes. Please take the time to be thoughtful and answer each question honestly. We are giving you, as the Little, the opportunity to share your voice, let us know how you are doing, and how your Big can better support you during your Match.

Child's Name(Required)

First Last

Child's Date of Birth(Required)

What is your cell number?

What is the name of your school?

What grade are you in?

Student ID

Developmental Assets Survey

Below is a list of posivitive things that you might have in yourself, your family, friends, neighborhood, school, and community. For each item that describes you now or within the last 3 months, check if the item is true: Not at all or Rarely, Somewhat or Sometimes, Very or Often, Extremely or Almost Always. If you do not want to answer an item, leave it blank. Please try to answer all items as best you can.

I tell other people what I believe in.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I can shape and influence what happens in my life and future.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I like myself.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I try not to do things that are dangerous or are not good for me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I enjoy reading or being read to.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I make friends with other people.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I care about school.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I do my homework.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I say no to things like smoking cigarettes, drinking alcohol, and "doing" drugs.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I enjoy learning.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I show my feelings in proper ways.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I feel good about my future.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I ask my parents for ideas when I need help.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I can be disappointed about something, but not get too upset.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I find good ways to handle things that are hard in my life.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I think it is important to help other people.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I feel safe at home.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I plan ahead and make good choices.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I stay away from bad people and bad things.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I fix problems I have without anyone getting hurt.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I feel like people like and respect me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I take responsibility for what I do.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I tell the truth even when it's not easy.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I accept people who are different from me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I feel safe at school.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I am trying to learn new things.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I think about what I want to do in my life when I grow up.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I am told to try things that might be good for me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I do chores at home and help make family decisions.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I help to make my school, neighborhood or city a better place.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I do things at a religious place, like a church.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I do healthy things like eat good food and get exercise.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I am told that it is a good thing to help other people.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I am part of a sports activity, a club, or other group.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I help with problems in the world, by doing things like donating to food shelves or giving money at church.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I am given important things to do at home, at school, or in my community.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I respect other people.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I want to do well in school and my other activities.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I am aware of other people's feelings and needs.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I spend time doing creative things like music, theater, or art.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I do things for others in my community.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I spend time at home doing things with my parent(s), or someone who is responsible for raising me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have friends who set good examples for me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a school that gives students clear rules.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have adults who are good role models for me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a safe neighborhood.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have parent(s) or someone who is responsible for raising me, who want me to do my best and help me do it.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have good neighbors who care about me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a school that cares about kids and and helps them learn.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have teachers who help me do my best.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have other adults in my life, who are not parents or someone who is responsible for raising me, who care about me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a family that sets clear rules for me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have parent(s) or someone who is responsible for raising me, who talk with me about doing well in school.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a family that gives me love and support.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have neighbors who help watch out for me.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have parent(s) or someone who is responsible for raising me, who are good at talking with me about things.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a school where every student has to follow the same rules.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

I have a family that knows where I am and what I am doing.

Not at all or Rarely

Somewhat or Sometimes

Very or Often

Extremely or Almost Always

Youth Outcome Survey

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

How sure are you that you will finish high school?

Not at all sure

Not really sure

Mostly sure

Very sure

How sure are you that you will go to college?

Not at all sure

Not really sure

Mostly sure

Very sure

How sure are you that you will finish college?

Not at all sure

Not really sure

Mostly sure

Very sure

In the next questions, think about how you feel when other kids your age do certain things.

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

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

It's not okay

It's sort of okay

It's mostly okay

It's perfectly okay

This next question asks about some behaviors you might have engaged in the past. 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?

Never

Yes, 1 to 2 times

Yes, 3 to 4 times

Yes, more than 5 times

Little’s Annual Survey