Campus Climate Survey Template

Anonymous campus climate survey template with 7 questions covering safety, belonging, and inclusion. Print, hand out, and scan completed forms for instant results.

Use this template

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 7 questions covering safety, belonging, fairness, and inclusion. The form prints on a single sheet and takes only a few 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. A single overall rating gives you a simple benchmark to track term over term, and an open comment box lets 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.

Questions in this template

  1. Please tell us how much you agree with each statement.
  2. How would you rate the overall campus climate?
  3. What would improve the campus experience?

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