An Evaluation of the Violence is Preventable (VIP) Program

Can you think of anything that would make the group even better
Appendix C: Pre and Post Grade 4+ Group Survey
Violence Is Preventable (VIP) PRE-Group Survey
To be completed by students grade 4 and up BEFORE group
BC/Yukon Society of Transition Houses – September 2008
The purpose of this survey is to find out a little bit about students who will be participating in a
VIP group. The choice to participate in the survey is up to you. Completed surveys will be seen
only by VIP staff working on the evaluation. All answers are anonymous (private) and will not be
shared with your school or family. No names will be used in any reports. Your feedback now
and at the end of the group is very important to us so we can make the groups even better.
1. Are you: Male or Female AGE: ___________
2. Are one or more of your parents Aboriginal First Nations, Metis, Inuit, non-status First Nations
Yes No Not sure
3. Were one or more of your parents born outside of Canada Yes No Not sure
Please circle the answer that best describes how true the sentence is for you.
Not at all
true
A little bit
true
Somewhat
true
Quite true
1. I get along well with other students. 1 2 3 4 5
2. I am a good listener. 1 2 3 4 5
3. I find it easy to talk about my feelings. 1 2 3 4 5
4. I can control my anger. 1 2 3 4 5
5. I attend school regularly. 1 2 3 4 5
6. I can solve problems with other people in 1 2 3 4 5
peaceful ways.
7. I ask for help when I need it. 1 2 3 4 5
8. I feel that I am a good person. 1 2 3 4 5
9. There is at least one adult who I can go to if 1 2 3 4 5
I need to talk.
10. I have at least one good friend. 1 2 3 4 5
11. I understand how violence can affect the 1 2 3 4 5
lives of people.
12. I feel that being in a group will give me a 1 2 3 4 5
place to talk about my thoughts and
feelings.
13. I am looking forward to being in a group. 1 2 3 4 5
Very
true
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