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(to download a printable PDF version, click here)
Name:_______________________________ Date:________________________________
School:______________________________ Grade:____________ Age:______________
Rate the extent to which each statement describes you. There are no right or wrong answers.
| Does not describe me at all | Describes me a little | Somewhat describes me | Moderately describes me | Definitely describes me | ||
| 1 | I believe that choices I make today can impact my family and community in the future. | 0 | 1 | 2 | 3 | 4 |
| 2 | When I trade with others, I get to know them better. | 0 | 1 | 2 | 3 | 4 |
| 3 | Being aware of what I am giving up helps me make choices. | 0 | 1 | 2 | 3 | 4 |
| 4 | I am more likely to do something if there is a reward for doing it. | 0 | 1 | 2 | 3 | 4 |
| 5 | My choices reflect what is important to me. | 0 | 1 | 2 | 3 | 4 |
| 6 | I think about future decisions more than past decisions. | 0 | 1 | 2 | 3 | 4 |
| 7 | When I trade something I value and don’t get something I value in return, I feel angry. | 0 | 1 | 2 | 3 | 4 |
| 8 | My choices are influenced by what I value. | 0 | 1 | 2 | 3 | 4 |
| 9 | My choices are limited by things other than my parents or other adults in my life. | 0 | 1 | 2 | 3 | 4 |
| 10 | Trading works better when I am honest about what I can do and what I want. | 0 | 1 | 2 | 3 | 4 |
| 11 | I don’t always feel like it is an even trade when I trade with my teacher or parents or other adults in my life. | 0 | 1 | 2 | 3 | 4 |
| 12 | I use my goals to guide choices I make. | 0 | 1 | 2 | 3 | 4 |
| 13 | I am accountable for the choices I make. | 0 | 1 | 2 | 3 | 4 |
| 14 | I have good relationships with people I meet in life. | 0 | 1 | 2 | 3 | 4 |
| 15 | It is important to consider costs and benefits before making a choice. | 0 | 1 | 2 | 3 | 4 |
| 16 | I cannot get what I need to be successful. | 0 | 1 | 2 | 3 | 4 |
| 17 | I compare the price of one item I want to another item I want to determine whether I should purchase it. | 0 | 1 | 2 | 3 | 4 |
| 18 | It is important to me to find out what I do best. | 0 | 1 | 2 | 3 | 4 |
| 19 | When making choices about my actions, I think about incentives and disincentives. | 0 | 1 | 2 | 3 | 4 |
| 20 | Choices often have several desirable options from which to choose initially. | 0 | 1 | 2 | 3 | 4 |
Rate the extent to which each statement describes you. There are no right or wrong answers.
| Does not describe me at all | Describes me a little | Somewhat describes me | Moderately describes me | Definitely describes me | ||
| 21 | I learn new things every day. | 0 | 1 | 2 | 3 | 4 |
| 22 | My success at school is influenced by the choices I make. | 0 | 1 | 2 | 3 | 4 |
| 23 | I can improve my life through education. | 0 | 1 | 2 | 3 | 4 |
| 24 | I have the resources available to get enough food to eat. | 0 | 1 | 2 | 3 | 4 |
| 25 | Money is not the only incentive that will convince me to change my behavior. | 0 | 1 | 2 | 3 | 4 |
| 26 | I compare the price of one item I want to the amount of time it would take me to earn that amount of money. | 0 | 1 | 2 | 3 | 4 |
| 27 | I sometimes trade the things I do best for other goods and services. | 0 | 1 | 2 | 3 | 4 |
| 28 | I share what I have based on how much people will give me in return. | 0 | 1 | 2 | 3 | 4 |
| 29 | I consider tangible costs (money, physical labor) when I make a choice. | 0 | 1 | 2 | 3 | 4 |
| 30 | I only put time and effort into a project if it will make me better off. | 0 | 1 | 2 | 3 | 4 |
| 31 | I only do things I feel like doing. | 0 | 1 | 2 | 3 | 4 |
| 32 | My choices are determined mostly by what my parents or other adults in my life have always done. | 0 | 1 | 2 | 3 | 4 |
| 33 | I believe the choices I make throughout life shape who I am as a person. | 0 | 1 | 2 | 3 | 4 |
| 34 | When I want people to do something for me, I think about a nice thing I can do for them in return. | 0 | 1 | 2 | 3 | 4 |
| 35 | I cannot change the future. | 0 | 1 | 2 | 3 | 4 |
| 36 | I consider intangible costs (safety, leisure time given up) when I make a choice. | 0 | 1 | 2 | 3 | 4 |
| 37 | I always think about possible choices I can make in the future. | 0 | 1 | 2 | 3 | 4 |
| 38 | Before making a choice, I identify and evaluate alternative choices. | 0 | 1 | 2 | 3 | 4 |
| 39 | My spending influences the amount suppliers produce. | 0 | 1 | 2 | 3 | 4 |
| 40 | I have the resources available to get a good night sleep on a regular basis. | 0 | 1 | 2 | 3 | 4 |
| 41 | Trading gives me lots of choices. | 0 | 1 | 2 | 3 | 4 |
| 42 | When I want people to do something for me, I think about how to force them to do it. | 0 | 1 | 2 | 3 | 4 |
| 43 | I make some choices in my life but most choices are made for me by my parents or other adults in my life. | 0 | 1 | 2 | 3 | 4 |
Rate the extent to which each statement describes you. There are no right or wrong answers.
| Does not describe me at all | Describes me a little | Somewhat describes me | Moderately describes me | Definitely describes me | ||
| 44 | If I do not make a choice something or someone else will make it for me. | 0 | 1 | 2 | 3 | 4 |
| 45 | I have a hard time overcoming past decisions. | 0 | 1 | 2 | 3 | 4 |
| 46 | Choices I make may have a cost to others and me. | 0 | 1 | 2 | 3 | 4 |
| 47 | I have freedom of choice in most areas of my life. | 0 | 1 | 2 | 3 | 4 |
| 48 | I learn from unanticipated outcomes in my life. | 0 | 1 | 2 | 3 | 4 |
| 49 | I believe things happen to me that I cannot change. | 0 | 1 | 2 | 3 | 4 |
| 50 | I consider the cost of an item to be more than money. | 0 | 1 | 2 | 3 | 4 |
| 51 | I have bartered something I had for something someone else had. | 0 | 1 | 2 | 3 | 4 |
| 52 | When I make choices, I have more control over situations. | 0 | 1 | 2 | 3 | 4 |
| 53 | I provide goods and services to people in my life. | 0 | 1 | 2 | 3 | 4 |
| 54 | In general, my friends are more likely to do what I want if I offer an incentive. | 0 | 1 | 2 | 3 | 4 |
| 55 | I can change my future by the choices I make today. | 0 | 1 | 2 | 3 | 4 |
| 56 | I consume goods and services every day. | 0 | 1 | 2 | 3 | 4 |
| 57 | I try to share what I have so that everyone gets the same amount no matter what I get in return. | 0 | 1 | 2 | 3 | 4 |
| 58 | I consider money to be the only incentive worth changing my behavior. | 0 | 1 | 2 | 3 | 4 |
| 59 | I have what I need to improve my life. | 0 | 1 | 2 | 3 | 4 |
| 60 | At this point, It is not important for me to understand how choices can influence my life. | 0 | 1 | 2 | 3 | 4 |
| 61 | When I am punished for doing something, I stop doing it. | 0 | 1 | 2 | 3 | 4 |
| 62 | When I do the things I do best, and my friends do the things they do best, we can get more work done than if I did everything by myself. | 0 | 1 | 2 | 3 | 4 |
| 63 | I re-evaluate my choice to purchase something when prices change. | 0 | 1 | 2 | 3 | 4 |