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| Student Name: | Grade/Class: | Date: |
Directions: Answer the questions to the best of your ability.
1. Describe at least three things you like about yourself.
2. Who are some of the people in your life who make you feel good about yourself and describe what they do to make you feel this way. (describe at least two)
3. Discuss some of the things that you do or have done in the past that give you a sense of achievement or accomplishment.
4. Rate each of the following factors on a scale of 1 to 5 (1 being very weak and 5 being very strong) to represent how important you think these things are to your own feelings of positive self esteem.
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_______ Family's income _______ Clothing I wear _______ Grades I make _______ Car we drive _______ My personal faith _______ Doing things for others |
_______ Neighborhood where we live _______ Friends I have _______ Support of parents and family _______ House I live in _______ Activities I participate in _______ Other: ________________ |
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