PBIS Earnings Questionnaire

Please help us improve our PBIS Earnings program by selecting a choice for each question below. We appreciate your feedback.

* Required

1. Would you prefer Eagle Dollars or Punches? *

2. Does your teacher give out Eagle dollars/punches during class? *

3. Have you ever been called down to the office for a Positive Behavior Referral? *

4. If not, would you like to be called to the office for a Positive Behavior Referral?

6. Would you prefer to_____________ *

7. Would you prefer to have ____________ *

8. Are you embarrassed when your teacher recognizes you with Eagle Dollars? *

9. How often do you want to spend Eagle Dollars? *

10. Are you embarrassed when given Eagle dollars in the hallway or cafeteria for good behavior? *

11. Would you like to receive more Eagle dollars/punches in fine arts, the hallways, and the cafeteria? *

12. What grade are you in? *

Name *