INTRODUCTION

This questionnaire is part of a project on Climate Action in My country

conducted by Uswatun Khasanah, M.Pd. , Teacher of SMP Negeri 22 Surabaya,
in the Indonesia-Korea Teacher Exchange Program (IKTE) in 2023.
The purpose of this questionnaire is to get information about students' understanding of Sustainable
Development Goals (SDG's) especially goal 13 (Climate Action) and to know the extent of students' role in
supporting climate change impacts through student actions from home and from their respective schools.
The information obtained will be used to complete the report on the "Climate Change in My Country"
project between students in Korea and students in Surabaya Indonesia.

STUDENT IDENTITY
SCHOOL

NAME/GRADE

CITY

QUESTIONNAIRE
You are asked to respond to each question by answering according to your knowledge!

INDICATOR 1
Understanding of the Sustainable Development Goals (SDGs) and Climate action goal 13

QUESTIONS ANSWERS
What do you know about the
Sustainable Development Goals
(SDG) adopted by the United Nations
and the countries that make it up?

What do you know about the

Sustainable Development Goals, goal
13, about climate action?

INDICATOR 2
 Affective
QUESTIONS ANSWERS
Do you know any weather
anomalies or abnormal weather
that are happening right now,
please mention if there are any
signs?

What caused the weather

anomaly?

Do you know that human life style

has a profound effect on climate
change?

What do you do if your family or

friends throw garbage away?

How do you feel about the

natural pollution?

INDICATOR 2
Psychomotor
QUESTIONS ANSWERS
What electronics do you use often
at home? Do you always turn off
after

How do you go to school or somewhere else? please give a check mark (√)

on foot by bike

by bus by car

What actions or actions can you take from home or from school to support the Sustainable Development Goals, goal 13, Climate Action?