Thank you for completing this survey. Your individual responses will not be shared with your parents/guardians, anyone from school, or program staff. We are requesting your name only to match responses before, during, and after the program. This survey is being used to improve the program for you and others. If after you take the survey, you want to talk to someone about how it made you feel, please seek out the staff member who asked you to take it.
What is your last name?
What is your first name?
What school do you attend?
How old are you?
What is your gender Identity (Select best choice)
Which of the following best describes your current school grades? (Select best choice)
Thinking of your parents or primary guardians, did they graduate from college?
The next questions ask about you and how you're doing outside of your outdoor experiential program.
For each statement below, click an answer on the right that describes how connected you feel to different people. For each statement below, click the answer on the right that describes your opinion about your school. Completely disagree Somewhat disagree Neither disagree nor agree Somewhat agree Completely agree
I have at least one friend I can talk to when something is bothering me.
I have at least one adult I can talk to when something is bothering me.
For each statement below, click the answer on the right that describes your opinion about your school. Completely disagree Somewhat disagree Neither disagree nor agree Somewhat agree Completely agree
I feel like I belong at my school.
At my school, other students accept me as I am.
Teachers at my school believe I can do well.
Teachers at my school would be willing to help me with a problem.
Move the Slider to the number that best reflects how you feel about your future. For each statement below, choose the response that best describes how you feel about your goals at this point in your life. Not at all likely Very Likely
How likely is it that you will go to college after high school?
How likely do you think it is that you will graduate from college?
How likely is it that you will find a job you like when you complete your education?
For each statement below, choose the response that best describes how you feel about your goals at this point in your life. None of the time A little of the time Some of the time A lot of the time Most of the time All of the time
I think I am doing pretty well.
Right now, I expect things to work out for the best.
I am doing just as well as other kids my age.
The future is looking bright to me
How do you feel about the things you do in your free time? For each statement below, click the answer on the right that best describes yourself. Not true for me Sometimes true for me Often true for me Always true for me
In my free time, I do interesting things.
In my free time, I try new things.
In my free time, I get to develop close relationships with others.
The things I do in my free time help me to stay healthy.
In my free time, I spend time in nature
For each statement below, click the answer on the right that best describes yourself. Never Rarely Sometimes Often Always
I know how to relax when I feel tense.
I am able to keep my feelings under control.
I know how to calm down when I am feeling nervous.
How often do you do the following things when you feel sad, disappointed, nervous, afraid, or experience other negative or unpleasant feelings?
When I feel sad, disappointed, nervous, afraid, or upset, ________________________.Never Rarely Sometimes Often Very Often
I withdraw and keep to myself
I try to find the positive in what has happened
I try to do something that will make me feel better
I speak with friends about how I feel
I speak with adults about how I feel
Below are statements that describe how people sometimes act when they feel angry. How often do the statements below apply to you when you feel angry? In the past 30 days, how often did you…
I lose my temper.
I hit, throw, or break things.
I physically harm myself or others
In the past 30 days, how often did you… During the past 30 days, on how many days did you... Never Rarely Sometimes Often Very often
…feel really sick?
…wake up feeling tired?
…tire easily or feel like you have no energy?
…have trouble sleeping?
...miss school because you didn't feel up to going?
…feel like your mental health was not good? (poor mental health includes stress, anxiety, depression)
During the past 30 days, on how many days did you... No times 1-2 times total 3-5 times total About once a month About once a week Nearly every day
...have at least 1 drink of alcohol
...smoke cigarettes or chew tobacco
...use an electronic vape product
...use marijuana
…take a prescription drug (such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor's prescription?
On an average school day, how many hours do you spend in front of a TV, computer, smart phone, or other electronic device watching shows or videos, playing games, accessing the Internet, or using social media (also called "screen time")? (Do not count time spent doing schoolwork.)
Less than 1 hour per day
1 hour per day
2 hours per day
3 hours per day
4 hours per day
5 or more hours per day
How risky do you think the following activities are? No risk Some risk More risk Great risk
Smoking one or more packs of cigarettes per day
Vaping/Juul every day
Having five or more drinks of alcohol per week
Using marijuana one or more times per week
Taking prescription medicine without a doctor's order