Team Assessment Form Step 1 of 16 6% Name* First Last Email* Enter Email Confirm Email Phone*School or Community Name* School Address* City State / Province / Region Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands # of Peer Leaders on your team* # of Adult Advisors on your team* How long has your team been going?* First Semester Year 1 Year 2 Year 3 Year 4 or more 1. Partnership Support (State, Provincial, Regional, other systems)* 0 - Our Sources program is not linked with any outside entities, coalitions, or groups. 1 - Our Sources program communicates with our state-provincial, regional, or coalitions about our efforts. They are aware. 2 - Our Sources program has shared funding, coordination, and training resources with other groups or have had our peer leaders present to coalitions. 3 - Our Sources program partners with a variety of groups and coalitions that are focusing on different issues. (i.e., – suicide, bullying, substance abuse, dating violence, LGBTQ, etc.) We are well known. 2. Administrative Support* 0 - Our administrator is not very supportive of Sources of Strength. 1 - Our administrator is aware of Sources of Strength and passively supportive. 2 - Our administrator actively supports Sources of Strength and makes time and space available for adult advisors and peer leaders. 3 - Our administrator is an active champion promoting Sources of Strength to staff, parents, other schools, and community agencies. 3. Adult Advisors* 0 - Our adult advisor/coordinator team does not work well together or does not find time to coordinate the program. 1 - Our Sources of Strength project has mainly one active adult advisor/coordinator who feels somewhat overwhelmed. 2 - Our Sources of Strength project has 2-3 adult advisors/coordinators that communicate and share responsibility. 3 - Our Sources of Strength project has an active group of adults/coordinators from both inside the school/agency and outside that work well together. 4. Peer Diversity* 0 - Our peer team is not very active or diverse. 1 - Our peer team is made up of good and active students but is not overly diverse. 2 - For our setting our peer team started with diverse students and we have been able to keep over 60% engaged. 3 - Our peer team is extremely diverse for our setting and we have been able to keep over 75% engaged 5. Peer Leader Ownership* 0 - Our peer team is driven almost totally by the ideas of the adult advisors. 1 - Our peer leaders wait for adult initiative before pursuing many ideas or adult advisors are using the peer leaders to initiate the adult ideas. 2 - Peer leaders actively facilitate most of the planning meetings, games, and are effective at organizing messages and activities. 3 - Peer leaders have high level of ownership, engaged diverse peer leaders in facilitating/ leading. Peer leaders are acting on many of their own ideas. 6. Staff and Other Adult Presentations* 0 - Our peer leaders have not presented to school staff, parents, or other outside groups about their Sources efforts. 1 - Our peer leaders have presented at least once to school staff, parents, or other adult groups about their efforts. 2 - Our peer leaders have presented at least once a semester to staff, parents, or other adult groups about their efforts. 3 - Our peer leaders have presented several times to staff, parents, or other groups and have also presented to school boards, councils or administrative groups. 7. Level of Peer Leader Activities* 0 - Our peer leaders did not successfully complete any activities or messaging campaigns. 1 - Our peer Leaders have conducted at least 1-2 activities or messaging campaigns. 2 - Our peer leaders have conducted at least 3-5 activities or messaging campaigns. 3 - Our peer leaders have conducted more than five activities or messaging campaigns reaching more than 75% of our students. Almost all students and staff know about Sources of Strength and have participated in an activity. Please elaborate.* 8. Peer Leaders Engaging Other Students* 0 - Our peer leaders have not engaged other students in conversations or activities involving Sources of Strength. 1 - Our peer leaders have conducted a few non-interactive activities that other students did not seem overly engaged in, i.e., gave presentations with powerpoints, but used few personal stories, or did not engage other students in sharing examples. 2 - Our peer leaders have conducted at least 2 interactive activities, shared personal strengths stories, and engaged some students in sharing strengths, naming trusted adults, or actively engaging in peer led activities. 3 - Our peer leaders have led very interactive activities, such as high level discussions with classes, small groups, or engaged many students in writing, art, videos, drama, or sharing about their strengths and supports. 9. Planning Meeting Frequency* 0 - Our peer leaders did not meet for the first two months after training. 1 - Our peer leaders met less than once a month for the first three months after training. 2 - Our peer leaders met at least 2x a month during the first three months after training. 3 - Our peer leaders met at least 2x a month during the first three months and continued to meet, plan, and implement ideas after that time. 10. Retention of Peer Leaders* 0 - We have less than 25% of the peer leaders involved that were originally trained 1 - We have between 25%-50% of the peer leaders involved that were originally trained. 2 - We have over 50% of peer leaders trained involved and active. 3 - We have over 75% of peer leaders trained, involved and active. 11. Recognition of Peer Leaders* 0 - Our peer leaders have received little or no recognition for being involved in Sources of Strength. 1 - Some of our more outstanding peer leaders have received some verbal thank yous. 2 - Our peer leader have been given personal recognition and recognition as a group within our school or community. 3 - Our peer leaders have received public and personal recognition in front of staff and other students and have had a celebration event for their accomplishments. 12. Fun Factor* 0 - Our peer leaders did not seem to enjoy planning meetings or doing peer to peer activities. 1 - Our peer leaders had fun doing activities that were occasionally led by adult advisors. 2 - Our peer leader regularly used humor, led fun games, and built fun into their activities and messaging events. 3 - Our peer leader team was contagious with it's fun and became known for leading great activities and enjoyable planning meetings. Other students want to get involved. 13. Core Messaging* 0 - Our peer leader team did not complete any of the core messaging activities. 1 - Our peer leader completed 1 of 3 of the following core messaging activities. 2 - Our peer leader team completed 2 of the 3 core messaging activities. 3 - Our peer leader team completed all 3 of the core messaging activities. A. Getting other students to publickly name or display trusted adults, mentors, etc. B. Interactive classroom or small groups where students talk or apply strengths to their life. C. Put on a Sources of Strength Week. What are your team's areas of greatest strength?*Describe why you scored high in certain areas.What are you team's areas of greatest challenge?*Describe why you scored low in certain areas.What would realistically help your Sources of Strength program meet these challenges?* Request a call back to discuss questions or concerns about your peer lead efforts.* Yes No Please offer a short description of the primary question or concern you would like to discuss.PhoneThis field is for validation purposes and should be left unchanged.
