Hip Hop 2015 - 2016 | CSC Student Pre-Assessment Survey

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* 1. Student Information

Name

Age

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* 2. My school is…

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* 3. My grade is…

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* 4. My race is...

Asian/ South Asian/ Pacific Island Descent

Biracial/ Multiracial

Black/ African Descent

Latina/o Descent

Middle Eastern Descent

Native/ Indigenous Descent

White/ European Descent

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* 5. My gender is…

Female

Male

Queer

Self-Identify (please specify)

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* 6. Restorative Practices / Communication and Collaboration:

	Disagree	Somewhat Agree	Agree	Strongly Agree
I am able to express myself in this class.	I am able to express myself in this class. Disagree	I am able to express myself in this class. Somewhat Agree	I am able to express myself in this class. Agree	I am able to express myself in this class. Strongly Agree
I am able to identify and express my feelings and needs.	I am able to identify and express my feelings and needs. Disagree	I am able to identify and express my feelings and needs. Somewhat Agree	I am able to identify and express my feelings and needs. Agree	I am able to identify and express my feelings and needs. Strongly Agree
I am able to communicate with people whose cultures or perspectives are different from mine.	I am able to communicate with people whose cultures or perspectives are different from mine. Disagree	I am able to communicate with people whose cultures or perspectives are different from mine. Somewhat Agree	I am able to communicate with people whose cultures or perspectives are different from mine. Agree	I am able to communicate with people whose cultures or perspectives are different from mine. Strongly Agree
When I experience conflict with others, I am able to handle it through communication.	When I experience conflict with others, I am able to handle it through communication. Disagree	When I experience conflict with others, I am able to handle it through communication. Somewhat Agree	When I experience conflict with others, I am able to handle it through communication. Agree	When I experience conflict with others, I am able to handle it through communication. Strongly Agree
When I experience conflict with others, I am able to consider their perspectives.	When I experience conflict with others, I am able to consider their perspectives. Disagree	When I experience conflict with others, I am able to consider their perspectives. Somewhat Agree	When I experience conflict with others, I am able to consider their perspectives. Agree	When I experience conflict with others, I am able to consider their perspectives. Strongly Agree
I am comfortable asking the teacher or peers if I need help with a question or conflict.	I am comfortable asking the teacher or peers if I need help with a question or conflict. Disagree	I am comfortable asking the teacher or peers if I need help with a question or conflict. Somewhat Agree	I am comfortable asking the teacher or peers if I need help with a question or conflict. Agree	I am comfortable asking the teacher or peers if I need help with a question or conflict. Strongly Agree

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* 7. Social Justice Frameworks:

	Disagree	Somewhat Agree	Agree	Strongly Agree	Not Applicable
I know myself and my culture.	I know myself and my culture. Disagree	I know myself and my culture. Somewhat Agree	I know myself and my culture. Agree	I know myself and my culture. Strongly Agree	I know myself and my culture. Not Applicable
I understand the difference between personal, social, and cultural identity.	I understand the difference between personal, social, and cultural identity. Disagree	I understand the difference between personal, social, and cultural identity. Somewhat Agree	I understand the difference between personal, social, and cultural identity. Agree	I understand the difference between personal, social, and cultural identity. Strongly Agree	I understand the difference between personal, social, and cultural identity. Not Applicable
I can name injustice when I experience or witness it.	I can name injustice when I experience or witness it. Disagree	I can name injustice when I experience or witness it. Somewhat Agree	I can name injustice when I experience or witness it. Agree	I can name injustice when I experience or witness it. Strongly Agree	I can name injustice when I experience or witness it. Not Applicable
I try to understand the sources of conflict and injustice.	I try to understand the sources of conflict and injustice. Disagree	I try to understand the sources of conflict and injustice. Somewhat Agree	I try to understand the sources of conflict and injustice. Agree	I try to understand the sources of conflict and injustice. Strongly Agree	I try to understand the sources of conflict and injustice. Not Applicable

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* 8. Arts Engagement: Hip Hop

What are the 4 elements of hip hop?

What are the 4 principles of hip hop?

What does P.E.E.P stand for?

Can you work with others to create a presentation?

What are 3 things you know about hip hop?