Peer Leadership Freshmen Growth Goals - (copy)

We are currently in the process of considering how the Peer Leadership program fits within the context of the Illinois Standards for Social and Emotional Learning, and collecting data on the growth our freshman students are able to achieve on these standards. Completion of this survey will provide us with valuable information about your student and how to proceed with program planning in the future.

A quick note on how the questions are set up. I have included the state goal for each standard (at the top of each question), and written the actual question to respond to in ALL CAPS. The actual state standards include specific indicators, which we have listed as examples [in brackets] below each question. Please do not feel restricted in responding to the question by these examples - feel free to interpret the question as you would naturally. There is also a free response box at the end if you would like to include any information that might be necessary to clarify survey items or would not be captured by any of the survey items.

Thanks again for your help!

[Student Name]
Name: 


  1. Goal 1:
    Develop self-awareness and self-management skills to achieve school and life success.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER IDENTIFY AND MANAGE HIS/HER EMOTIONS AND BEHAVIOR?

    [Some examples might be: Analyzing how thoughts and emotions affect decision making and responsible behavior, or generating ways to develop more positive attitudes]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 1:
    Develop self-awareness and self-management skills to achieve school and life success.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER RECOGNIZE PERSONAL QUALITIES AND EXTERNAL SUPPORTS?

    [Some examples might be: Setting priorities in building on strengths and identifying areas for improvement, or analyzing how positive adult role models and support systems contribute to school and life success]

     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 1:
    Develop self-awareness and self-management skills to achieve school and life success.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER DEMONSTRATE SKILLS RELATED TO ACHIEVING PERSONAL AND ACADEMIC GOALS?

    [An example might be: Identifying and utilizing strategies to overcome obstacles to goal achievement]

     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 2:
    Use social-awareness and interpersonal skills to establish and maintain positive relationships.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER RECOGNIZE THE FEELINGS AND PERSPECTIVES OF OTHERS?

    [Some examples might be: Analyzing similarities and differences between one’s own and others’ perspectives, or using conversation skills to understand others’ feelings and perspectives]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 2:
    Use social-awareness and interpersonal skills to establish and maintain positive relationships.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER RECOGNIZE INDIVIDUAL AND GROUP SIMILARITIES AND DIFFERENCES?

    [Some examples might be: Analyzing the origins and negative effects of stereotyping and prejudice, or demonstrating respect for individuals from different social and cultural groups]

     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 2:
    Use social-awareness and interpersonal skills to establish and maintain positive relationships.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER USE COMMUNICATION AND SOCIAL SKILLS TO INTERACT EFFECTIVELY WITH OTHERS?

    [Some examples might be: Evaluating the effects of requesting support from and providing support to others. or evaluating one’s contribution in groups as a member and leader]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 2:
    Use social-awareness and interpersonal skills to establish and maintain positive relationships.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER DEMONSTRATE AN ABILITY TO PREVENT, MANAGE AND RESOLVE INTERPERSONAL CONFLICTS IN CONSTRUCTIVE WAYS?

    [Some examples might be: Analyzing how listening and talking accurately help in resolving conflicts, or analyzing how conflict-resolution skills contribute to work within a group]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 3:
    Demonstrate decision-making skills and responsible behaviors in personal, school, and community contexts.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER CONSIDER ETHICAL SAFETY AND SOCIETAL FACTORS IN MAKING DECISIONS?

    [Some examples might be: Demonstrating personal responsibility in making ethical decisions, evaluating how social norms and the expectations of authority influence personal decisions and actions]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 3:
    Demonstrate decision-making skills and responsible behaviors in personal, school, and community contexts.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER APPLY DECISION-MAKING SKILLS TO DEAL RESPONSIBLY WITH DAILY ACADEMIC AND SOCIAL SITUATIONS?

    [Some examples might be: Evaluating personal abilities to gather information, generate alternatives, and anticipate the consequences of decisions, or applying decision-making skills to establish responsible social and work relationships]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Goal 3:
    Demonstrate decision-making skills and responsible behaviors in personal, school, and community contexts.

    TO WHAT EXTENT DOES YOUR SON OR DAUGHTER CONTRIBUTE TO THE WELL-BEING OF ONE’S SCHOOL AND COMMUNITY?

    [Some examples might be: Planning, implementing, and evaluating one’s participation in activities and organizations that improve school climate or the community]
     
      1 2 3 4 5  
    Not at all  All the time


  1. Please feel free to include any information that would help us interpret your responses: