Q01
Message
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High School Dropout Reasons And Reengagement Survey
Understands why students leave high school before earning a diploma and what conditions might bring them back, for school districts, counselors, and youth-reengagement programs. An AI follow-up interview reconstructs the specific turning point behind the decision to leave, going deeper than a single checkbox reason.
Sample questions
A preview of what’s in the template. Every question is editable before you launch.
12 questions · ~7 min
Q02
Multiple ChoiceRequired
What grade were you in when you last attended school?
- Before 9th grade
- 9th grade
- 10th grade
- 11th grade
- 12th grade
- Not sure
Q03
Multiple ChoiceRequired
Which of these was the biggest reason you stopped attending?
- Falling behind or failing classes
- Needed to work to support myself or my family
- Family responsibilities (caregiving, moving, etc.)
- Bullying or feeling unsafe at school
- Pregnancy or parenting
- Suspension, expulsion, or trouble with school discipline
- Lost interest or didn't see the value in finishing
- Mental health or physical health issues
Q04
Best–Worst Trade-off (MaxDiff)
Beyond the main reason, several things can push a decision to leave school. Which of these mattered most, and which mattered least, in your situation?
- Grades were falling behind
- Classes felt disconnected from my future plans
- Needed income for my family
- Tension with teachers or school staff
- Peer relationships or bullying
- Transportation or getting to school reliably
- Mental health struggles
- Instability at home
Pick best & worst per setBest:Mattered mostWorst:Mattered least
Q05
Matrix
Thinking back to your last year in school, how much do you agree with each statement?
5 rows × 5 columns
- A teacher or staff member noticed I was struggling
- I felt like I belonged at that school
- I understood how my classes connected to my future goals
- I could get help when I fell behind academically
- The school offered flexible options (schedule, online, credit recovery) that fit my life
Columns: Strongly disagree · Disagree · Neutral · Agree · Strongly agree
Q06
AI Interview
Reconstruct the specific turning point that led this person to leave school: what was happening in the weeks before, whether they told anyone, and whether they considered other options at the time. Anchor on the primary reason they selected, and ask what — if anything — a teacher, counselor, or family member could have done differently to change the outcome. If they describe multiple compounding factors, ask which one was the final tipping point.
Q07
Multiple Choice
Which best describes what you're doing now?
- Working full-time
- Working part-time
- Enrolled in a GED or diploma-completion program
- Enrolled in a vocational or trade program
- Not currently working or studying
Q08
Opinion Scale
How likely are you to enroll in a program to finish your diploma or GED in the next 12 months?
Scale: 0 – 10
Min:Not at all likelyMax:Extremely likely
Q09
Long Text
If one thing had been different — at school or at home — what would have kept you enrolled until graduation?
Q10
Multiple Choice
What is your age range?
- Under 16
- 16-17
- 18-19
- 20-24
- 25 or older
- Prefer not to say
Q11
Multiple Choice
What is your gender?
- Woman
- Man
- Non-binary
Q12
Message
Thank you for sharing this — it isn't always easy to talk about. Your answers will be combined with others to help schools and programs better support students before and after they consider leaving.
What’s included
AI follow-ups
Adaptive probes on open-ended answers that pull out detail a static form would miss.
Attention checks
Built-in safeguards against rushed answers and low-quality respondents.
AI-drafted copy
Wording, ordering, and branching written by the AI — tuned to your research goal.
Auto report
Themes, quotes, and a plain-English summary write themselves once responses come in.
How it compares
We reviewed the closest templates from other survey tools. Here’s what they do well — and where this template goes further.
Why this template
- Includes an AI follow-up interview that reconstructs the specific turning point behind a student's decision to leave, rather than stopping at a single checkbox reason
- Pairs a max-diff exercise on secondary push factors with a matrix of agreement statements about the student's final year, giving both breadth and depth on causes
- Asks directly about likelihood to re-enroll in a diploma/GED program and what one changed condition (at school or home) would have kept them in, feeding directly into reengagement planning
- Opens and closes with supportive chat messages acknowledging the sensitivity of the topic, which matters for a population that may be wary of institutional surveys
QuestionPro
High School Dropout Questionnaire & Sample Survey TemplateThis is a static sample questionnaire covering dropout reasons with fixed question lists, presented as a downloadable/reference template rather than a fielding-ready adaptive survey. It's a genuine topical match for districts and counselors researching dropout causes. The page functions more as a question-bank example than a tool that adapts to each respondent's story.
What it does well
- Directly on-topic sample question set for dropout research
- Likely easy to customize within QuestionPro's broader survey platform
- Backed by an established survey company with wide template library
Where it falls short
- No adaptive AI follow-up questioning — respondents get the same fixed items regardless of their answers, so the specific turning point behind leaving is never reconstructed
- No voice AI interview option or guided screen-share tasks
- No visible per-response quality scoring or transparent prompt methodology
Ready to launch?
Open this template in the editor. Every part is yours to change before the first respondent sees it.