B-94, Parisima Complex, Near Lal Bungalow

LionsQuestinIndiaFoundation

B-94, Parisima Complex, Near Lal Bungalow,

C. G. Road, Ahmedabad - 380 006, Gujarat

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Lions Quest Skills for Adolescence - Pre Test Questionnaire

(For Students joining SFA Classes. Answer Yes/No or in Short)

Are you aware that during your teen years, you undergo certain changes?Yes/ No

Are your physical changes causing you any worry?Yes / No

Do you try to look at the mirror often?Yes / No

Are you aware of the talents you have?Yes / No

Do you interact with your parents frequently?Yes / No

Do you share your thoughts more with your friends?Yes / No

Do you ask questionto teachers for your personal matter?Yes / No

Are you afraid of expressing yourself?Yes / No

Are you able to speak to any one?Yes / No

Do you like to have friends from opposite sex?Yes / No

Do you feel loneliness or boredom?

(a)Some time or very rarely

(b) On a specific occasion/situation

(c)Very often

(Select any one) ______

Do you have many friends, only one or two, or more? ______

Do your likes and dislikes change?

(a)Very often

(b)Do not change at all

(c)Change every week

(Select any one) ______

Are you able to control your anger? Yes / No

If yes, what do you do?

(a) Become quite

(b) Become rude

(Select any one) ______

Do you respect other’s feelings or you insult them? ______

Do you like togo with your parents for picnic / outings?Yes / No

Do you like the company of your friends for picnic more than your parents?Yes / No

Do you take food together with your family members?Yes / No

You tell your parents everything that happens at school or home?Yes / No

Would you like yourparents to spend more time with you Yes / No

Do you obey your parents?

(a) Willingly

(b) By force

(Select any one) ______

Is bullying is problem in your school? Yes/No

Do you pay attention when in class?

(a) When your teacher speak

(b)Other class fellows speak (Select any one)______

(Select any one) ______

Are you friendly with

(a) Everyone

(b) Only friends

(Select any one) ______

If your friend offers you a Cigarette, Pan Masala or Alcohol

(a)Do you try to taste?

(b) Say no to him/her?

(Select any one) ______

Do you know that addiction of above all are harmful to yourself? Yes / No

Do you like to learn new things & new skills?Yes / No

Do you manage your day to day work by your own? eg. Home work, arranging school bag,get ready for school on time etc. Yes / No

Do you boast about yourself / or your things with your classmates?Yes / No

Do you try to impress your friends,brothers & sisters?Yes / No

Do you like to follow family rules?Yes / No

Do you like to help others? Yes / No

Do you like to serve someone known or unknown to you? Yes / No

Do you like to speak the truth? Always / Sometimes

(Select any one) ______

Do you blame others when things go wrong?Yes / No

Do you return things borrowed from your friends?Yes / No

Your best friends are not talking with you? How do you feel?

______

Do you like to make friends? What qualities would you choose in your friends? Name any three

______

If your friends force you to do something wrong, what do you do?

(a)Say no

(b)Be quite and follow them

(Select any one)______

Would you like to know more about Decision Making Skills? Problem Solving Skills?Yes / No

What would you like to be in your life? Your goal? (Doctor, Engineer, Teacher, Dancer, Model, Sportsman, Journalist or any other)

(Select any one and answer) ______

Do you know what you will have to do to achieve your goal? Describe in Short?

______

Lions Quest Skills for Adolescence - Pre Test QuestionnairePage 1