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Please complete the attached anonymous survey. Your responses will be strictly confidential and can never be linked to you. You may stop at any time. The data you provide will be part of an Intel National Science Talent Search entry. Please answer each question directly and honestly. Your effort is greatly appreciated.

Thank You!
 
 
 
* What is your gender?
 
Male
 
Female
 
 
 
Your Ethnicity (Select all that apply)?
 
White/Caucasian
 
Black/African American
 
Spanish/Hispanic/Latino
 
South Asian/Indian
 
Middle Eastern
 
Chinese
 
Korean
 
Japanese
 
South East Asian
 
Native American
 
Other Asian
 
Mixed
 
Other

 
 
 
Were you born in the US?
 
Yes
 
No
 
 
 
What is your GPA?
 
A+ (97-100)
 
A (94-96)
 
A- (90-93)
 
B+ (87-89)
 
B (84-86)
 
B- (80-83)
 
C+ (77-79)
 
C (74-76)
 
C- (70-73)
 
D (66-69)
 
F (below 65)
 
 
 
How satisfied are you with your academic performance?
 
Not at all satisfied
 
Slightly satisfied
 
Moderately satisfied
 
Very satisfied
 
Extremely satisfied
 
 
 
Are you satisfied with your GPA?
 
Not at all satisfied
 
Slightly satisfied
 
Moderately satisfied
 
Very satisfied
 
Extremely satisfied
 
 
 
Do you believe your GPA needs improvement?
 
Not at all
 
Slightly
 
Moderately
 
Very
 
Extremely
 
 
 
Do you often wish that your GPA was higher?
 
Not at all
 
Seldomly
 
Sometimes
 
Often
 
All the time
 
 
 
Are you often trying to raise your GPA?
 
Not at all
 
Seldomly
 
Sometimes
 
Often
 
All the time
 
 
 
How many minutes per week do you attend extra-help at school? (1 session of extra help is 40 minutes, if you go to extra help 3 times a week, then 40x3=120 minutes per week)
   
 
 
 
How many minutes per week do you employ a tutor? (ANY TYPE OF TUTORING INCLUDING SAT/ACT AND SUBJECT)(1 hour session with tutor is 60 minutes. If you spend two hours with a tutor weekly, then 60x2=120 minutes)
   
 
 
 
How many minutes per week do you ask your family members (parents or siblings) for help with academics?
   
 
 
 
How many minutes per week do you ask peers for help with academics?
   
 
 
For each of the following items, please indicate the degree to which you feel the statement or characteristic is true of you:
Not at all Slightly Moderately Very Extremely
I get nervous if I have to speak with someone in authority (teacher, boss, principal etc.)
I have difficulty making eye contact with others.
I become tense if I have to talk about myself or my feelings.
I find it difficult to mix comfortably with my peers or the people I work with.
I find it easy to make friends my own age.
I tense up if I meet an acquaintance in the street.
When mixing socially, I am uncomfortable.
I feel tense if I am alone with just one person, regardless of the person.
I am at ease meeting people at parties, etc.
I have difficulty talking with other people.
Not at all Slightly Moderately Very Extremely
I find it easy to think of things to talk about.
I worry about expressing myself in case I appear awkward.
I find it difficult to disagree with another's point of view.
I have difficulty talking to people I find attractive.
I find myself worrying that I don't know what to say in social situations.
I am nervous mixing with people I don't know well.
I feel I'll say something embarrassing when talking.
When mixing in a group, I find myself worrying I will be ignored.
I am tense mixing in a group.
I am unsure whether to greet someone I know only slightly.
 
 
 
IN THE PAST WEEK:
 
 
How many times have you participated in each class? (If you typically participate in class 5 times, and you have 7 classes a day, you multiple 5x7=35. Then 35x5 (school days)=175 times of participation)
   
 
 
How many assignments (NOT including tests) have you turned in? (If you had 7 assignments last week, and you only turned in 5, then your answer is 5/7 assignments)
   
 
 
How many times has a teacher corrected your behavior?
   
 
 
 
IN THE PAST ACADEMIC YEAR:
 
 
Have you been disruptive when class is taking place?
 
Not at all
 
Seldomly
 
Sometimes
 
Often
 
All the time
 
 
Did teachers often have to correct your behavior?
 
Not at all
 
Seldomly
 
Sometimes
 
Often
 
All the time
 
 
How many times were you kicked out of a class?
   
 
 
How many times has a teacher emailed your parents complaining about your behavior?
   
 
 
How many times has your teacher phoned your house complaining?
   
 
 
For each of the following items, please indicate the degree to which you feel the statement or characteristic is true of you:
Not at all Slightly Moderately Very Extremely
I fear failure.
I am often concerned that I will not do well on a test.
I often study hard for a test.
I am concerned about the repercussions if I fail a test.
I don’t find myself concerned about tests and grades.
I get nervous the day before a test.
I try hard in class because I don’t want to fail.
I am often concerned about grades.
I feel disappointment if I don’t pass an exam.
I find it difficult to cope with a failing grade.
I am concerned about failing.
 
 
For each of the following items, please indicate the degree to which you feel the statement or characteristic is true of you:
Not at all Slightly Moderately Very Extremely
I am able to connect concepts being taught in class to previous topics.
I generally understand what is being taught in class.
I can take what I am learning and interpret it.
I have little difficulty keeping up with discussions in class.
I don't have trouble with difficult homework.
I can coach others about most topics because I understand it really well.
I am very good at application questions.
I can take previous knowledge and apply it to new knowledge.
I am very good with making connections.
 
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