WV1 Post-Assessment Character Development- Afterschool Program

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Beginning of 2022-2023 School Year (List B)

Student Name *

Student Grade *

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

Does PLAYING music change the way you feel (your emotions?) *

Yes

I don't really know

Sometimes

Does PLAYING music bring you good feelings (happiness, peace, joy?) *

Yes

I don't really know

Sometimes

Does LISTENING to music change the way you feel? *

Yes

Sometimes

I don't really know

Does listening to music bring you good feelings? (happiness, peace or joy?) *

Yes

Sometimes

I don't really know

Are you a musician? *

Yes

I don't know

Sometimes

Do you have friends in Sistema? How many? *

2-3 (a couple)

4-5 (a few)

5+ (many)

I get my homework done each night. *

Yes

Sometimes

I have learned about these Builder themes this year in Sistema: *

I am a Builder when I Build with Enthusiasm

I am a Builder when I Demonstrate Integrity

I am a Builder when I Express Gratitude in Word and Deed

I am a Builder when I look for ways to serve others (Kigatsuku)

I am a Builder when I think positive thoughts about myself and others

I am a Builder when I use my words to encourage others

I am a Builder when I quickly acknowledge mistakes and humbly make amends

I am a Builder when I face obstacles with determination and positivity

I am a Builder when I respect my body and mind

I have not learned about any of these builder themes this year in Sistema.

Required

Questions about applying Builder themes: I Build with Enthusiasm *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I Demonstrate Integrity *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I Express Gratitude in Word and Deed *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I look for ways to serve others (Kigatsuku) *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I think positive thoughts about myself and others *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I use my words to encourage others *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I quickly acknowledge mistakes and humbly make amends *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I face obstacles with determination and positivity *

Always

Usually

Sometimes

Not really

Questions about applying Builder themes: I respect my body and mind *

Always

Usually

Sometimes

Not really

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