b Click on the icon to access the ASCA National Model Templates and Tools Leadership Resources: Perception Survey Creator Perception Data Survey CreatorPlease select the Mindset Standard that best aligns to your lesson plan. M 1. Belief in development of whole self, including a healthy balance of mental, social/emotional and physical well-being M 2. Sense of acceptance, respect, support and inclusion for self and others in the school environment M 3. Positive attitude toward work and learning M 4. Self-confidence in ability to succeed M 5. Belief in using abilities to their fullest to achieve high-quality results and outcomes M 6. Understanding that postsecondary education and lifelong learning are necessary for long-term success Please select the Behavior Standards that best align with your plan. B-LS 1. Demonstrate critical-thinking skills to make informed decisions B-LS 2. Demonstrate creative approach to learning, tasks and problem solving B-LS 3. Use time-management, organizational and study skills B-LS 4. Apply self-motivation and self-direction to learning B-LS 5. Apply media and technology skills to enhance learning B-LS 6. Set high-quality standards for tasks and activities B-LS 7. Identify long- and short-term academic, career and social/emotional goals B-LS 8. Actively engage in challenging coursework B-LS 9. Gather evidence and consider multiple perspectives to make informed decisions B-LS 10. Participate in enrichment and extracurricular activities B-SMS 1. Demonstrate ability to assume responsibility B-SMS 2. Demonstrate self-discipline and self-control B-SMS 3. Demonstrate ability to work independently B-SMS 4. Demonstrate ability to delay immediate gratification for long-term rewards B-SMS 5. Demonstrate perseverance to achieve long- and short-term goals B-SMS 6. Demonstrate ability to overcome barriers to learning B-SMS 7. Demonstrate effective coping skills when faced with a problem B-SMS 8. Demonstrate the ability to balance school, home and community activities B-SMS 9. Demonstrate personal safety skills B-SMS 10. Demonstrate ability to manage transitions and ability to adapt to changing situations and responsibilities B-SS 1. Use effective oral and written communication skills and listening skills B-SS 2. Create positive and supportive relationships with other students B-SS 3. Create relationships with adults that support success B-SS 4. Demonstrate empathy B-SS 5. Demonstrate ethical decision-making and social responsibility B-SS 6. Use effective collaboration and cooperation skills B-SS 7. Use leadership and teamwork skills to work effectively in diverse teams B-SS 8. Demonstrate advocacy skills and ability to assert self, when necessary B-SS 9. Demonstrate social maturity and behaviors appropriate to the situation and environment B-SS 10. Cultural awareness, sensitivity and responsiveness Select Domains Social/Emotional Career Academic Social/Emotional Bond with school Bullying Mentor Student School Climate Student Study Skills Relationship Skills Responisble Decision-Making Social Awareness Self Management Self Awareness College Culture Career Confidence Goal Setting Responsibility College Plans Academic Academic Self Esteem Student Learning Student Testing Time Management Bond with School-Likert Most of my teachers understand me. My teacher knows what I like and don’t like. Most of my teachers like me. I like my teachers. The rules in my school are fair. I feel valued at school. I am proud of my school. All in all, I feel I’ve been very fortunate to have had the kinds of teachers I’ve had since I’ve started school. Bullying at School-Likert Bullying is not a problem at my school. I have never been bullied by other students. I've never seen people bullied for the way they look. I've never seen people bullied because of their friends. I've never seen people bullied for their sexual orientation. I am not afraid of bullying/teasing at school. Good grades/Showing interest in school has never caused myself/others to be bullied. Affects of Bullying-Likert Bullying/Teasing does not upset me. Bullying does not affect my grades. Bullying has never caused me to skip school. Students care about each other at my school. Students at my school support each other. Students at my school get along together. Students at my school look out for one another. Students at my school treat each other with respect. Bullying and Safety-Likert I feel safe at school. I have several good school friends. I have an adult I can talk to at school about bullying. The punishment for a bully is severe at my school. I feel that my school actively deters bullying. I feel safe in class and around my school. I feel safe in the hallways and bathrooms. I don't worry about crime and violence in my school. I feel safe when security is present. I feel safe attending class every day. My Mentor-Likert My mentor likes me. I like my mentor. My mentor cares about how well I do in school. My mentor gives me confidence. My mentor has helped me improve my grades. I respect my mentor. I would like to spend more time with my mentor. My mentor has helped me enjoy school. My mentor helps me with my personal problems. I meet with my mentor more than three times per week. My mentor and I do many great things together. Student School Climate-Likert I am treated kindly at school. My school is a friendly place. I am able to learn in my classroom. The teachers in my school listen to the students. My school is neat and clean. My parents have been invited to my school. People volunteer at my school. The cafeteria is a good place to eat lunch. The playground is safe and fun. People say nice things about my school. The counselor's office is a good place to go. I am told about the rules in my school. The rules in my school are fair to everyone. The media center is a good place to find books. I feel safe at my school. How I Study-Likert I show good listening skills. I take responsibility for my actions. I am on time to school. I turn in homework on time. I complete my class work. I accept mistakes as a way to learn. I show a positive outlook about learning. I know good ways to study for tests. I behave well. I have an organized desk. Relationship Skills-Likert My friends and I enjoy sharing some interests, but also have some separate interests. I try to do my share when I am working or playing with another student. I feel like I am part of a team when I am working with other students. Sometimes I make fun of other people so I will fit in. I compliment others when they do something well. Responsible Decision Making-Likert When I don’t understand something, I ask questions and keep trying. Learning new things is fun. I care about getting good grades. I come to class with my homework finished. Social Awareness-Likert I feel like I fit in at my school. Self Management-Likert I am usually in a good mood. I listen carefully to directions. If I don't understand something at first, I keep trying. I am easily distracted when doing my schoolwork. Self-Awareness-Likert I notice how my feelings affect how I act. I know what I am good at and what is hard for me. How Confident Do You Feel?-Likert I feel confident meeting someone for the first time. I feel confident trying something new for the first time. I feel confident going to new places. I feel confident traveling to a new place alone. I feel confident speaking out loud in class. I feel confident working on a math problem with a friend. I feel confident getting new homework to do at school. I feel confident getting something right when I feel pressured. I feel confident figuring something out by myself. I feel confident giving an oral book report in class. I feel confident making an important decision. Goal Setting-Likert I set goals for myself every day. I should meet every goal I set for myself. Setting goals helps me do well in school. I can set goals for school and home. Adults must set goals for themselves. Student Responsibility-Likert I take responsibility for my actions at home. I take the responsibility to make sure I turn in my homework. I take the responsibility to say I am “sorry” when I am wrong. Being responsible will help me do well in school. I choose friends who are responsible. My teacher expects me to do my best all the time. My teacher expects everyone to work hard. My teacher has encouraged me to continue my education after high school. My teacher thinks it is important for students to attend every class. My teacher connects what I am learning in the classroom to my life outside of the classroom. Academic Self Esteem-Likert I expect to do well in school. School is interesting. I can learn even the hardest subjects if I put my mind to it. I am an important person in my classes. School is easier for me than most other people. I am usually proud of my report card. I often feel valued in school. Doing well in school is important to me. When I try hard in class, I get good grades. I usually complete my homework and turn it in on time. The teacher really listens to what I say. The teacher gives me extra help on school work if I need it. My teacher helps me catch up if I am behind. My teacher notices if I have trouble learning something. My teacher would be willing to help me with a personal problem. There are people in the school that would help me if I need it. Student Learning-Likert I can recognize three different styles of learning. I can identify what learning style best describes me. I understand that all of the students in my class have different learning styles. I know studying strategies for each learning style. Student Testing-Likert I must study for standardized tests. Before a test I usually eat a good breakfast. It is not important to finish first on a test. I try to get a good night of sleep before a test. I like taking tests. Student Time Management-Likert I am on time for school. I turn in my homework on time. I think that being on time is important. I have good time management skills. Being organized helps me manage my time wisely. I notice how others feel when I am late. College Planning I have finalized my plans for after high school and need to be contacted by my counselor. My high school was helpful in addressing my career interests and abilities. My high school was helpful in developing my career plan. My high school was helpful and provided information about occupations. My high school was helpful and taught job search techniques. My high school helpful in teaching resume writing. My high school was helpful and helped me find a job. My high school was helpful and taught me interviewing skills. My counselor has met with me often this year. My counselor has been very helpful in the development of my plan for after high school. My counselor has helped me select courses that meet my high school graduation requirements. My counselor has helped me select courses that I need for work or admission to college. My counselor has helped me decide what I want to do after I graduate. My counselor has encouraged me to take AP/honors courses. My counselor has encouraged me to continue my education after high school. My counselor has talked to me about how to get a job. My counselor has talked to me about colleges/schools that are suited for my abilities and interests. College Culture I plan to attend college. I will be the first in my family to go to college. My family would really like for me to go to college. Most of my friends plan to go to college. I've thought about what colleges I might want to go to. My teachers think that I am college material. I know someone who can help me apply to and get into college. I know that I can get into college if I just work hard enough. There is nothing preventing me from going to college. My family thinks I need a college education. I'm likely to get a better paying job if I go to college. I think that I could qualify for financial aid for college. I think I will be able to afford to go to college. I know how I can get the money I need to go to college. I know the steps to take to apply for financial aid for college. College is worth the cost. My family and I have already started saving money for me to go to college. A high school diploma is not as good as a college degree in today's job market. I know the classes I need to take in order to get accepted into college. I know where to get information about getting into the college I want. Grades are not the only thing that matters in getting accepted into a good college. I'm involved in extracurricular activities at school. Δ
