Campus Climate Survey Template

Anonymous campus climate survey template with 20 questions covering safety, belonging, inclusion, and support. Print, hand out, and scan completed forms for instant results.

Print this ready-made questionnaire and hand it out, then scan and upload the completed forms to read the answers automatically. You can also share the same questionnaire online. The preview below shows the paper version.

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Copy this template into your account, then customize it to suit your needs.

This printable campus climate survey helps colleges and universities gather anonymous feedback from students across 20 questions covering safety, belonging, fairness, inclusion, and support. The form prints on three pages and takes about ten minutes to complete, so you can reach every student rather than only those who open a survey email.

What this survey measures

The survey captures how students experience campus life day to day. A rating grid measures agreement with statements about personal safety, a sense of belonging, fair treatment regardless of background, awareness of support services, and whether the campus feels inclusive and welcoming. Further sections cover where students feel safe, experiences of harassment and reporting, and how easy it is to reach support services. An overall climate rating gives you a simple benchmark to track term over term, a few optional background questions let you compare groups, and two open comment boxes let students describe, in their own words, what would improve the campus experience.

How to use it on paper

Hand copies out in lecture halls, at student union events, in residence common rooms, or during orientation sessions, and set up a sealed collection box so responses stay anonymous. Students fill the checkboxes with a blue or black pen. Collect the completed forms and scan them in batches: PaperSurvey reads the checkbox answers with optical mark recognition and converts the handwritten comments to text automatically, so results appear in your dashboard without any manual data entry.

Customize this template

Add your institution logo, reword the statements to match your community and terminology, or add sections for specific colleges, residence halls, or year groups. The paper layout reflows automatically as you edit, and every copy you print stays scannable.

Preview the PDF above, or use this template to start collecting campus climate feedback today.

Paper and web from one template

Use this questionnaire on paper, online, or both, and collect all responses in one place. Open it in a new tab. This is a preview only. Responses are not saved.

Questions in this template

  1. Please tell us how much you agree with each statement.
  2. How often do you feel isolated or left out on campus?
  3. How safe do you feel in each of these places?
  4. Overall, how safe do you feel on campus after dark?
  5. Which of these would make you feel safer?
  6. Please tell us how much you agree with each statement.
  7. This year, have you faced or seen harassment or discrimination on campus?
  8. If you experienced or witnessed it, did you report it?
  9. If something concerned you, would you know how to report it?
  10. How confident are you that a report would be taken seriously?
  11. How easy is it to get help from each of these services?
  12. Have you used any campus support service this year?
  13. How would you rate the overall campus climate?
  14. Compared with a year ago, how has the campus climate changed?
  15. How likely are you to recommend this campus to a friend?
  16. What is your year of study?
  17. How do you attend?
  18. Where do you live during term?
  19. What would improve the campus experience?
  20. Is there anything else you would like us to know?

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