Sex *

Please enter the sex you identify with

Male

Female

Other

Do you fall under BAME or White Other? *

Please select yes or no

Yes

No

Do you have a disability? *

The Disability Discrimination Act 1995 defines a disabled person as anyone with ‘a physical or mental impairment, which has a substantial long-term adverse effect on his or her ability to carry out normal day-to-day activities’.

Yes

No

Do you have any leaning needs? *

Learning needs in this instance for the benefit of this monitoring request means seeking support for special education needs and disabilities (SEND)

Yes

No

Are you currently excluded from school? *

Yes

No

Have you ever been excluded from school?

This question is optional

Yes

No

As a result of this / these activities, have you improved self-esteem? *

Yes

No

As a result of this / these activities, have you developed problem solving skills? *

Yes

No

As a result of this / these activities, have you developed resilience? *

Yes

No

I've been feeling optimistic about the future *

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I've been feeling useful *

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I've been feeling relaxed *

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I've been feeling interested in other people *

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I've had energy to spare *

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I've been deeling with problems well *

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I've been thinking clearly *

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I've been feeling good about myself *

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I've been feeling close to other people *

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I've been feeling confident *

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I've been able to make up my own mind about things *

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I've been feeling loved *

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I've been interested in new things *

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I've been feeling cheerful *

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