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Date
MM
/
DD
/
YYYY
Building
Your answer
Who asked you to cover class/period?
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Administrator
Secretary
Colleague
Para-educator
Other
How long were you providing coverage?
1 period
1/2 day
all day
Other:
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Were you asked to cover during your prep period?
Yes
No
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Did you want to say no, but felt pressured?
I said no but was told I had to (direct pressure/directive)
I wanted to say no but felt indirect pressure from the person asking me (guilt-trip)
I agreed to do it, but don't want to in the future and am not sure how to say no (if you choose to give your name in "other" we will contact you to help)
Other:
Clear selection
Other comments
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