Together for Change – Evaluation 2 – English Evaluation Form 2 for students, English Basic Data All fields are mandatory ID*Please use the code provided by your teachersAge*10-1212-1415-19Gender*MaleFemaleNon-binaryAgenderMy gender is not listedPrefer not to answerNationality*Select a schoolxxxCountry of Residence*Please select your countryBelgiumCroatiaGreeceHungaryItalyPortugalSerbiaSpainOtherIf other please indicate which:*Please select your countryAfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweProvince (Belgium)*AntwerpBrabantWest FlandersEast FlandersHainautLiègeLimburgLuxembourgNamurOtherProvince (Croatia)*DalmatiaKvarnerCentral CroatiaIstriaSlavoniaOtherProvince (Greece)*AtticaCreteSouthern AegeanNorthern AegeanEpirusCentral GreeceWestern GreeceIonian IslandsCentral MacedoniaWestern MacedoniaEastern Macedonia and ThracePeloponneseThessalyOtherProvince (Hungary)*BaranyaBács-KiskunBékésBorsod-Abaúj-ZemplénCsongrád-CsanádFejérGyőr-Moson-SopronHajdú-BiharHevesJász-Nagykun-SzolnokKomárom-EsztergomNógrádPestSomogySzabolcs-Szatmár-BeregTolnaVasVeszprémZalaOtherProvince (Italy)*AbruzzoValle d'AostaPugliaBasilicataCalabriaCampaniaEmilia-RomagnaFriuli-Venezia GiuliaLazioLiguriaLombardiaMarcheMolisePiemonteSardegnaSiciliaTrentino-AltoToscanaUmbriaVenetoOtherProvinces (Portugal)*AzoresAveiroBejaBragaBragançaCastelo BrancoCoimbraÉvoraFaroGuardaLeiriaLisbonMadeiraPortalegrePortoSantarémSetúbalViana do CasteloVila RealViseuOtherProvinces (Serbia)*VojvodinaBelgradeŠumadija and Western SerbiaSouthern and Eastern SerbiaOtherProvince (Spain)*La CoruñaÁlavaAlbaceteAlicanteAlmeríaAsturiasÁvilaBadajozIslas BalearesBarcelonaVizcayaBurgosCáceresCádizCantabriaCastellónCiudad RealCórdobaGuipúzcoaGironaGranadaGuadalajaraHuelvaHuescaJaénLa RiojaLas PalmasLeónLéridaLugoMadridMálagaMurciaNavarraOrensePalenciaPontevedraSalamancaSanta Cruz de TenerifeSegoviaSevillaSoriaTarragonaTeruelToledoValenciaValladolidZamoraZaragozaOtherProvince (Other)*School*Select a schoolsara0512saraesHUHEZISaraES4sara4itSara2ITLiceo Scientifico Statale Enrico FermiPROVAITSARASARAITSaraSARAHUNGSARASARAAl nour1Al Nour2This is not a real applicationECO UNESCO Youth Section 1: Your participation in the curriculum Please select the appropriate answers.I participated in the curriculum in…* School A youth group Other Which other?*I participated in the curriculum…* For one class period For one whole day For 2-7 class periods For 8 class periods On multiple whole days Other Which other?*I participated in the curriculum as part of…* Regular classwork A special day/event Other Which other?*I studied the CHANGE Environment curriculum as part of my class in… (If you participated in the curriculum in class at school)* Religion Politics Social studies/sciences Philosophy A language Geography History Other Not applicable If other which?*As part of the curriculum, I studied…* Select All Stage 1: Exploring self-awareness Stage 2: Receiving and processing critical information Stage 3: Changing perspectives Stage 4: Forming and representing judgements Stage 5: Dealing with prejudices Stage 6: Getting into action Did you have the opportunity to meet a refugee or a migrant in your class during the project?* Yes No What kind of activities have you implemented or are you planning to implement?* Public policy meeting, event or debate Exhibition, show or cultural event Social media activity and/or campaign Local community-based activity School-based activity Other No activity planned If other, which?* Evaluation Ante – Together for CHANGE Curriculum Introduction: Please answer the following question based on a scale from 1 to 5, where: 1 means Strongly Disagree – You completely disagree with the statement. 2 means Disagree – You somewhat disagree with the statement. 3 means Neutral – You neither agree nor disagree with the statement (you’re unsure or have no opinion). 4 means Agree – You somewhat agree with the statement. 5 means Strongly Agree – You completely agree with the statement I am aware of my personal values and how they affect my choices (values are the things that are most important to you in life. They are the beliefs and ideas that guide how you act, make decisions, and interact with others. )*12345I am interested in learning more about the topic of migration*12345I feel that I understand the topics of refugees and migration well*12345I make sure that the information I use for research (whether for school or personal use on the internet) comes from trustworthy sources*12345I form and give my opinions about migration based on research and careful thought*12345When engaging in discussions about migration, I listen to differing opinions, even if I disagree*12345I am aware when someone in a conversation (it can be myself) use a generalization to talk about a person or group:*12345 Evaluation Ante – Together for CHANGE Curriculum Introduction: Please answer the following question based on a scale from 1 to 5, where: 1 means Strongly Disagree – You completely disagree with the statement. 2 means Disagree – You somewhat disagree with the statement. 3 means Neutral – You neither agree nor disagree with the statement (you’re unsure or have no opinion). 4 means Agree – You somewhat agree with the statement. 5 means Strongly Agree – You completely agree with the statement I feel confident to intervene when I witness prejudice or discrimination.*12345I am comfortable receiving feedback from others about my opinions or assumptions about people*12345I believe it is important for everyone, including myself, to contribute to creating a more inclusive society by standing up against racism and supporting diversity:*12345I believe it is important to engage in activities that promote diversity and inclusion*12345EmailThis field is for validation purposes and should be left unchanged. 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