Weekly Responsibility for Behavior Survey

Name


  1. I solved all problems peacefully.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I have taken full responsibility for my mistakes this week.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always kept my hands and feet to myself.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I turned in all assignments and forms between home and school.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always refrained from interrupting while my teacher or others were talking.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always cleaned up after myself and kept my workspace clean.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always followed the rules of no bullying and put-downs.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always raised my hand and waited my turn to speak.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always respected items that belonged to someone else.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always paid attention to what I was doing by rereading directions and checking my work before turning it in.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always listened when others were speaking or performing.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always refrained from using verbal and body language to belittle, mock, or bully others.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always practice my homework and reread chapters at home to prepare for the next day.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I was always honest and truthful.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always spoke in a courteous/polite manner, tone, and volume this week.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always used school materials, property, and equipment for its intended purpose this week.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always refrained from carrying on and disturbing others during class/school functions.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always deferred to those in authority to handle problems on the playground and in the classroom.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I always followed classroom and school rules.
      1 2 3 4 5  
    Strongly agree   Strongly disagree


  1. I was always on task.
      1 2 3 4 5  
    Strongly agree   Strongly disagree





fourth grade
McGrath Elementary