NAI 9-10 PHYSICAL EDUCATION SURVEY 2007-2008

Instructions: Please answer each question completely and click once on the submit button when you have finished.  Print a copy of the Confirmation page that appears after you click on the submit button and turn it in to your physical education teacher.
Grading: Your grade depends on you accurately completing the assignment, not on your fitness scores.  The assignment is worth 100 points total, you will lose 10 points for each of the 5 required fitness tests that have not been completed or excused in either fall or spring testing.  You will receive a grade of 0 if your Fitness Pre and Post Test Data is not entered exactly as directed.
Use of data: The information that you submit will be used to establish fitness and health trends within North Allegheny School District and to determine the need for curriculum modifications.  We ask for your name only to insure the accuracy of the information that you are providing.  At no time will an individual be identified in relation to this data.

Personal Data:

Last Name:    First Name:   Id#:

Birth date: / /    

Current grade:       Gender:           

Teacher:         Course: 

Fitness Test Pre and Post Data: (If you did not complete the test enter your score as 0.)
*One of the 5 required assessments.

*15 Minute Heart Rate Run/Walk (Enter distance as a decimal example7.1)
Fall: Distance Laps,   Avg. Heart Rate    Reason for not completing
Spring: Distance Laps,  Avg. Heart Rate    Reason for not completing

*Push-ups
Fall: adaptation Repetitions    Reason for not completing
Spring: adaptation Repetitions    Reason for not completing

*Pull-ups (Enter reps as a decimal exp. 2.25 if you recorded quarter reps)
Fall: Repetitions     Reason for not completing
Spring: Repetitions    Reason for not completing

*Timed  20 Minute XC Run (Enter distance as a decimal exp. 2.3)
Fall: Distance:    Avg. Heart Rate         Reason for not completing
Spring: Distance:     Avg. Heart Rate       Reason for not completing

*1 Minute Sit-Up Test (Enter repetitions completed in 1 minute)
 Fall: Repetitions   Reason for not completing        
Spring: Repetitions  Reason for not completing

Body Fat % (Enter Score as a decimal exp. 15.5, if you did not get tested type NS.)
Permission:
Fall Score:       Spring Score:

PACER Test (Enter a score if your class completed it.)
Winter Score:      Max HR Achieved:         Spring Score:      Max HR Achieved:

Sit and Reach (Enter scores to the nearest half inch)
Fall: Inches         Spring: Inches

Survey Questions:

Physical Fitness and Activity

  1. I think I am physically fit.
  2. How do you rate your athletic skill level compared to others your age?
  3. How do you rate your fitness level compared to others your age?
  4. I have begun to participate in these selected activities outside of class. (You must click on an item to select it, hold down the Ctrl key and click to select more than one item.)
  5. I saw the value in (rate each unit); Running ,  Yoga , 
    Biking ,  Strength Training , 
    Self Defense ,  Pickleball   
  6. I will be more physically active outside of school as a result of physical education.
  7. I know how to develop a fitness plan.
  8. Presently I participate in interscholastic sports.

Nutrition

  1. I understand the concept of caloric balance to maintain a healthy weight.
  2. I have reduced the number of empty calories I consume to maintain a healthy weight.
  3. My knowledge of what it means to eat healthy has improved this year.
  4. My nutritional habits have improved.

 

Reflections

  1. I feel physical education is fun.
  2. I feel physical education is rewarding.
  3. I feel physical education is an important class.
  4. I know what I am getting graded on in physical education.
  5. I try hard in physical education.
  6. I am afraid of making mistakes in front of others in PE.
  7. How could this class better meet your needs?
  8. Why do you believe that you did or did not improve on your fitness scores?
  9. What did you learn in this class, what were the most valuable lessons? 
  10. What is your number one complaint about physical education?
  11. This class met my expectations.
  12. Did you improve on your aerobic fitness tests?
  13. Did you improve on your muscular strength and endurance tests?
  14. Do you feel a sense of accomplishment based on your spring fitness scores compared to your fall scores?

Just click one time on the Submit button, Do not double click.