Your
Sex (check one): ____ Male ____ Female Form 20
What
is your age?: ____
INSTRUCTIONS: This instrument is designed to measure your
feelings, beliefs and behaviors concerning your interactions with others. It is not a test, so there are no right or
wrong answers. Please answer the
questions as honestly as possible.
Using the scale below, indicate your level of agreement or disagreement
in the space which is next to each statement.
1 2
3 4 5
Strongly Disagree Undecided
Agree Strongly
Disagree
Agree
___
1. Helping others is usually a waste of
time.
___
2. When given the opportunity, I enjoy
aiding others who are in
need.
___
3. If possible, I would return lost
money to the rightful owner.
___
4. Helping friends and family is one of
the great joys in life.
___
5. I would avoid aiding someone in a
medical emergency if I
could.
___
6. It feels wonderful to assist others
in need.
___
7. Volunteering to help someone is very
rewarding.
___
8. I dislike giving directions to
strangers who are lost.
___
9. Doing volunteer work makes me feel
happy.
___10. I donate time or money to charities every
month.
___11. Unless they are part of my family, helping
the elderly isn’t
my responsibility.
___12. Children should be taught about the
importance of helping
others.
___13. I plan to donate my organs when I die with
the hope that they
will help someone else live.
___14. I try to offer my help with any activities
my community or
school groups are carrying out.
___15. I feel at peace with myself when I have
helped others.
___16. If the person in front of me in the
check-out line at a store
was a few cents short, I would pay the difference.
___17. I feel proud when I know that my generosity
has benefited a
needy person.
___18. Helping people does more harm than good
because they come
to rely on others and not themselves.
___19. I rarely contribute money to a worthy cause.
___20. Giving aid to the poor is the right thing to
do.