SURVEY for Student Respondents:

Please respond to the following questions on gender issues in education. Be as thorough as

possible in your answers. Please return the form in the enclosed envelope by ____________.
All responses will remain anonymous.

Demographics (Age, Address, Level in school)

❏ Age _________
❏ Gender
❏ Male;
❏ Female;
❏ Intersex
❏ School level __________________
❏ Father’s Age and Occupation ____________________________________
❏ Mother’s Age and Occupation ____________________________________
❏ Siblings (how many and their age) _________________________________

PART 1: Gender Equity

In questions 1-3, please reflect on your own experiences when you were in a level lower than
you’re in now. If you’re in Grades 1-6, think about your experiences as a preschooler, and if
you’re in Grades 7 to Senior Highschool, think about your experiences as a first, second, third,
fourth, etc. grader.

1. Recalling your own school experiences, which of these activities were common interests
of girls in school? Check all that apply.
___ pretend play activities
___ rough-and-tumble physical pay
___ cooperative play activities
___ hands-on exploration (manipulating/taking apart objects)
___ other (please explain) ___________________________________
___ other (please explain) ___________________________________

Which of these activities were common interests of boys in school? Check all that apply.
___ pretend play activities
___ rough-and-tumble physical pay
___ cooperative play activities
___ hands-on exploration (manipulating/taking apart objects)
___ other (please explain) ___________________________________
___ other (please explain) ___________________________________

2. How did your teacher discipline girls? Check all that apply.
___ name/check marks on the board or discipline sheet
___ verbal redirection or warning in front of the class
___ visit to the principal's office
 ___ private conference with the student
___ time out or removal of an activity
___ extra work/writing sentences
___ other (please explain) ___________________________________

How did your teacher discipline girls? Check all that apply.
___ name/check marks on the board or discipline sheet
___ verbal redirection or warning in front of the class
___ visit to the principal's office
___ private conference with the student
___ time out or removal of an activity
___ extra work/writing sentences
___ other (please explain) ___________________________________

3. Was there ever a time that you wished you were another gender? If so, at approximately
what age? Please describe.

For the remainder of the questions, please reflect on your current experiences as a student.
Think of your typical classrooms for the past 2-3 years:
4. In your classroom today, which of these activities were common interests of girls in
school? Check all that apply.
___ pretend play activities
___ rough-and-tumble physical pay
___ cooperative play activities
___ hands-on exploration (manipulating/taking apart objects)
___ other (please explain) ___________________________________
___ other (please explain) ___________________________________

Which of these activities were common interests of boys in school? Check all that apply.
___ pretend play activities
___ rough-and-tumble physical pay
___ cooperative play activities
___ hands-on exploration (manipulating/taking apart objects)
___ other (please explain) ___________________________________
___ other (please explain) ___________________________________

5. Consider this scenario: On the playground/paying field a group of boys are going to play
a ball game. Several girls want to play, but are told by the boys that they cannot. What
do you do?

Do you think it is helpful for girls and boys to occasionally have separate play activities?
 For questions 6-12, encircle your answer.
6. In general, who do you think consumes more instructional attention in your classroom
(i.e, who needs more assistance with academic tasks)?
a. Boys
b. Girls
c. No Difference

7. The students who require more discipline in your typical classroom are:
a. Boys
b. Girls
c. No Difference

8. In general, who do you think talks more, or in general dominates the class?
a. Boys
b. Girls
c. No Difference

9. During group activities, who are the leaders in your classroom?

a. Boys
b. Girls
c. No Difference

10. In your curriculum materials, who is generally shown in lead roles?

a. Boys
b. Girls
c. No Difference

11. In your classroom, the students who seem to excel in the subjects of math and science
are:
a. Boys
b. Girls
c. No Difference

12. In your classroom, the students who seem to excel in the subjects of reading and
language arts are:
a. Boys
b. Girls
c. No Difference

13. Does the teacher ever seat or group students according to boys or girls? If so, please
explain.
PART 2: Gender Discrimination

14. What do you think are the causes of gender discrimination in general?

15. Do you think gender inequality exists in this school?

16. Do you think gender inequality exists in this school?

17. Do you feel you have ever been turned down from an opportunity because of your gender?

18. Have you ever experienced gender inequality/gender discrimination?

a. If yes, where was it? Check all that apply.

__ Home
__ School
__ Other (please specify)
b. Who did you experience the inequality/discrimination from? Check all that apply.
__ Classmate
__ Schoolmate
__ Teacher
__ Prefer not to say
c. If yes, have you talked to anyone about this? To whom?

19. Has a classmate of yours ever experienced gender inequality/gender discrimination?

a. If yes, what is it about? Check all that apply.

__ Subject admissions
__ Club/Org recruitments
__ Financial aid
__ Grading
__ Classroom assignment
__ Counseling
__ Guidance
__ Academic programs and opportunities
__ Discipline
__ Prefer not to say
20. Do you identify yourself as LGBT?

21. Have you seen examples of anti-LGBT name-calling, bullying or harrassment in your
school?

If yes, how are students, including you, affected by anti-LGBT bias at your school?

22. If you do not identify as LGBT, how would you feel if people thought you were LGBT?

23. If someone were to come out to you as LGBT, what would your first thought be?

24. How do you think these inequalities could be improved, both for the students and the
teachers, as part of the school’s regulations and policies?