Civic Responsibility Survey

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Civic Responsibility Survey

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Thank you for taking this Civic Responsibility Survey

*1. Survey Taken:

Beginning of semester End of semester

*2. Instructor:

*3. Please answer the following questions as accurately as possible:

Strongly Agree Agree Slightly Agree Slightly Disagree Disagree Strongly Disagree

I have a strong and personal attachment to a particular community.

I often discuss and think about how political, social, local or national issues affect the community

I participate in political or social causes in order to improve the community.

It is my responsibility to help improve the community.

I benefit emotionally from contributing to the community, even if it is hard and challenging work.

I am aware of the important needs in the community.

*4. Continue with the next set of questions:

Strongly Agree Agree Slightly Agree Slightly Disagree Disagree Strongly Disagree

I feel a personal obligation to contribute in some way to the community.

I am aware of what can be done to meet the important needs in the community.

Providing service to the community is something I prefer to let others do.

I have a lot of personal contact with people in the community.

Helping other people is something that I am personally responsible for.

I feel I have the power to make a difference in the community.

*5. Continue with the next set of questions:

Strongly Agree Agree Slightly Agree Slightly Disagree Disagree Strongly Disagree

I often try to act on solutions that address political, social, local, or national problems in the community.

It is easy for me to put aside my self-interest in favor of a greater good.

I participate in activities that help to improve the community, even if I am new to them.

I try to encourage others to participate in community service.

Becoming involved in political or social issues is a good way to improve the community.

I believe that I can personally make a difference in the community.

*6. Continue with the next set of questions:

Strongly Agree Agree Slightly Agree Slightly Disagree Disagree Strongly Disagree

I believe that I can have enough influence to impact community decisions.

I am or plan to become actively involved in issues that positively affect the community.

Being concerned about state and local issues is an important responsibility for everybody.

Being actively involved in community issues is everyoneís responsibility, including mine.

I try to find time or a way to make a positive difference in the community.

I understand how political and social policies or issues affect members in the community.

**The Civic Responsibility Survey (1998) was developed by A. Furco, P. Muller, and M.S. Ammon at the Service Learning Research and Development Center at the University of California, Berkeley*

Civic Responsibility Survey • Last update time: Aug 14, 2005 06:31 PM • Disclaimer