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2023-2024 JCS FRYSC Middle/High School Youth Survey
Dear Students,
Please complete this survey to help us decide what programs/activities will be offered here at Jackson City School. Your answers will remain anonymous so please be honest. Thank you!
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* Indicates required question
Grade
*
6th
7th
8th
9th
10th
11th
12th
Basic Needs: Do you need help with or worry about: Check all that apply.
*
Having food at home
Having the supplies you need for school
Becoming homeless
Having clothes to wear that fit
Having supplies needed to stay healthy (toothpaste/brush, soap, shampoo, etc.)
Utilities turned off at home (electric, water, etc.)
Getting a good night's sleep
None
Other:
Required
Mental/Physical Health: Do you need help with or worry about: Check all that apply.
*
Dental Care
Medical Services
Vision/Hearing Care
Information on nutrition (exercise, diet, weight control)
Stress Management
Dealing with divorce
Grief - Dealing with the death of a family member or friend
Anger Management
Parent/family member in jail
Getting along with friends
Getting bullied by others
Self-esteem (Feeling good about yourself)
Violence in school
Fitting in
Getting along with teachers
Planning for the future (what you want to be when you grow up)
Teen pregnancy - Including Birth Control and Postponing Sexual Involvement
Teen Counseling
Physical/Verbal/Emotional Abuse at home
Conflict Resolution/Peer Mediation (so you don’t get into fights at school)
Alcohol Use
Nicotine Use (Including Vaping/Juuling)
Marijuana and prescription drug use
Suicide prevention for self and/or friend
Planning for the future: college, job training and employment
Information on planning/paying for college and/or career
Friends on Social Media (Facebook, Snapchat, Twitter, etc.)
Opportunities to volunteer/serve others
None
Other:
Required
I feel pressured to experiment with drugs/tobacco alcohol by relatives and/or friends:
*
Never
Sometimes
Regularly
I use tobacco products.
*
Never
Sometimes
Regularly
I use alcohol products.
*
Never
Sometimes
Regularly
I use vaping products (Vape Pens/Juul Pens).
*
Never
Sometimes
Regularly
I use marijuana and/or prescription drugs that aren't mine:
*
Never
Sometimes
Regularly
What are your academic needs? Check all that apply.
*
Tutoring
Homework Help
Attendance
Information on Careers
Planning for college
School supplies
Other:
Required
What top three social/emotional concerns facing teens today? (anger, bullying, stress, etc.)
*
Your answer
What are some activities that interest you? (art, clubs, drama, music, etc.)
*
Your answer
When would you like to do these activities?
*
Before School
After School
Summer
Weeekends
Required
Can your family bring you to activities when school is out?
*
Yes
No
Sometimes
Do you ride the school bus?
Morning and After School
Morning only
After School only
Sometimes when my parents need me to
Never
Clear selection
HIGH SCHOOL STUDENTS ONLY: How confident are you in your job application, resume writing and interviewing skills?
Very Confident
Somewhat Confident
Not very confident (I need help in these areas.)
Clear selection
If you need more information on anything mentioned in this survey, please contact Mrs. Ashley Combs in the FRYSC. Call 606-666-5089 or stop by.
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