United Way Youth Venture Spring 2009 Team Member Survey
There are some error(s). Please see each marked section below.
Required Question(s)
Progress:
About Me
1.
Please enter the information indicated below.
First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
-- Select a state --
-- Non U.S. --
Alabama
Alaska
Alberta
Arizona
Arkansas
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
British Columbia
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Manitoba
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Brunswick
New Hampshire
New Jersey
New Mexico
New York
Newfoundland and Labrador
North Carolina
North Dakota
Northwest Territories
Nova Scotia
Nunavut
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
Saskatchewan
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Yukon Territory
Postal Code:
2.
Which school or community organization do you participate in UWYV through? Select all that apply.
Leominster High School
Leominster High School
Skyview Middle School, Leominster
Skyview Middle School, Leominster
Memorial Middle School, Leominster
Memorial Middle School, Leominster
Leominster Center for Technical Education
Leominster Center for Technical Education
Murdock Middle High School
Murdock Middle High School
21st Century After-School Program, Fitchburg
21st Century After-School Program, Fitchburg
Fitchburg High School
Fitchburg High School
Francis W. Parker Charter School
Francis W. Parker Charter School
Shirley Middle School
Shirley Middle School
Lura White Elementary School, Shirley
Lura White Elementary School, Shirley
BF Brown, Leominster
BF Brown, Leominster
Other
3.
LEOMINSTER STUDENTS
: Which UWYV teams do you belong to? If more than one, please list all teams (additional teams listed in question #4).
If you do not attend Leominster schools, please skip on to the question pertaining to your school district.
Leadership Venture
Leadership Venture
Mums & Muffins
Mums & Muffins
C.L.A.S.S. - Classroom Learning Activities for Samoset Students
C.L.A.S.S. - Classroom Learning Activities for Samoset Students
L.E.A.F.S. - Learning Environment Activities for Students
L.E.A.F.S. - Learning Environment Activities for Students
Operation Photojournalism
Operation Photojournalism
Project Launchpad
Project Launchpad
Tech Awareness Venture
Tech Awareness Venture
C.O.M.P. - Community Outreach Mural Project
C.O.M.P. - Community Outreach Mural Project
Little People's Literature
Little People's Literature
S.T.A.M.P. - Students Taking Action in Massachusetts Politics
S.T.A.M.P. - Students Taking Action in Massachusetts Politics
Wildcat Wares Wagon
Wildcat Wares Wagon
The Buzz Literary Magazine
The Buzz Literary Magazine
Giving Back to the Community
Giving Back to the Community
Willing to Help Venture - Queriendo Ayudar
Willing to Help Venture - Queriendo Ayudar
Traveling Through the World
Traveling Through the World
L.A.N.D. - Leominster Advocates for Nature's Den
L.A.N.D. - Leominster Advocates for Nature's Den
Hawk's Nest
Hawk's Nest
Backyard Group Venture
Backyard Group Venture
Positive Pre-School Pals
Positive Pre-School Pals
Teen Reach
Teen Reach
4.
LEOMINSTER STUDENTS
: Which of the following UWYV teams do you belong to? Please select all that apply (additional Leominster teams listed in above question).
Freedom Venture
Freedom Venture
Devil Pups
Devil Pups
Samoset Gazette
Samoset Gazette
Teen Generational Service Venture
Teen Generational Service Venture
Other
5.
SHIRLEY STUDENTS
: Which of the following UWYV teams do you belong to? Please select all that apply.
If you do not attend Shirley schools, please move on to the question pertaining to your school district.
Shirley Bakes
Shirley Bakes
Shirley School Store
Shirley School Store
E.T.C. - Energy Through Creativity
E.T.C. - Energy Through Creativity
Good Sport
Good Sport
Kids at Play
Kids at Play
SAFE
SAFE
Charity Garden
Charity Garden
S.A.F.A. - Shirley Arts for All
S.A.F.A. - Shirley Arts for All
SMS Literary Magazine
SMS Literary Magazine
Fix It Up Wrap It Up
Fix It Up Wrap It Up
S.O.S. - Skaters of Shirley
S.O.S. - Skaters of Shirley
The Rolled Up Newspaper - For the Kids By the Kids
The Rolled Up Newspaper - For the Kids By the Kids
Shirley Penguins
Shirley Penguins
T.R.U.N. 2 - SMS
T.R.U.N. 2 - SMS
Supplies for Good
Supplies for Good
Food Dudes
Food Dudes
Shirley School Mascot
Shirley School Mascot
T&J Basketball Venture
T&J Basketball Venture
Group 5
Group 5
Other
6.
FRANCIS W. PARKER CHARTER STUDENTS
: Which of the following UWYV teams do you belong to? Please select all that apply.
If you do not attend Parker Charter, please move on to the question pertaining to your school district.
Team Ultimate
Team Ultimate
Club PAGE
Club PAGE
Parker STAND
Parker STAND
Puppy Love
Puppy Love
Other
7.
WINCHENDON STUDENTS
: Which of the following UWYV teams do you belong to? Please select all that apply.
If you do not attend Winchendon schools, please move on to the question that pertains to your school district.
Extreme Makeover: Field Edition
Extreme Makeover: Field Edition
The Sound of Murdock
The Sound of Murdock
Operation Murdock Cares
Operation Murdock Cares
Wii Care
Wii Care
Other
8.
FITCHBURG STUDENTS
: Which of the following UWYV teams do you belong to? Please select all that apply.
If you do not attend Fitchburg schools, please move on to the question pertaining to your school district.
Riverfront Revival of the Arts
Riverfront Revival of the Arts
From Crocker to Crocker
From Crocker to Crocker
STAGES
STAGES
Life-Link
Life-Link
Intergenerational Venture
Intergenerational Venture
Prom Dress Express
Prom Dress Express
Red Raider Rock Band
Red Raider Rock Band
Other
9.
21st CENTURY AFTER-SCHOOL STUDENTS
: Which of the following UWYV teams do you belong to? Please select all that apply.
If you do not participate in the 21st Century After-School program, please move on to the question pertaining to your school district.
E.S.P. - Eco-School Project
E.S.P. - Eco-School Project
P.A.T.H. - Peer Academic Tutoring Help
P.A.T.H. - Peer Academic Tutoring Help
Other
10.
How long have you been on a United Way Youth Venture (UWYV) team?
Less than 6 months
Less than 6 months
6 months to less than 1 year
6 months to less than 1 year
1 year to less than 3 years
1 year to less than 3 years
3 years to less than 5 years
3 years to less than 5 years
5 years or more
5 years or more
11.
How frequently do you work on your Venture?
10+ hours each week
10+ hours each week
7-9 hours each week
7-9 hours each week
4-6 hours each week
4-6 hours each week
1-3 hours each week
1-3 hours each week
A couple times a month
A couple times a month
Once a month
Once a month
Once or twice a year
Once or twice a year
12.
How satisfied have you been with your UWYV experience this year?
Highly satisfied
Highly satisfied
Somewhat satisfied
Somewhat satisfied
Neutral
Neutral
Somewhat dissatisfied
Somewhat dissatisfied
Highly dissatisfied
Highly dissatisfied
13.
Do you plan to participate in UWYV next year?
Very likely
Very likely
Somewhat likely
Somewhat likely
Neutral
Neutral
Somewhat unlikely
Somewhat unlikely
Very unlikely
Very unlikely
Comment:
500 character(s) left.
14.
How would you describe your racial and/or ethnic background? Please check all that apply.
American Indian or Alaskan Native
American Indian or Alaskan Native
Asian
Asian
African-American
African-American
Cape Verdean
Cape Verdean
Native Hawiian/Pacific Islander
Native Hawiian/Pacific Islander
Latino/Hispanic
Latino/Hispanic
Caucasion/White
Caucasion/White
Prefer not to answer
Prefer not to answer
Other
15.
What is your gender?
Male
Male
Female
Female
Prefer not to answer
Prefer not to answer
16.
How old are you?
12
12
13
13
14
14
15
15
16
16
17
17
18
18
19
19
20
20
21+
21+
Under 12
Under 12
17.
What grade are you in at school?
1st - 4th
1st - 4th
5th
5th
6th
6th
7th
7th
8th
8th
Freshman
Freshman
Sophomore
Sophomore
Junior
Junior
Senior
Senior
College
College
Other
18.
Which of the following other activities do you participate in? Please mark all that apply.
Sports
Sports
School Clubs (Key Club, Kiwanis, Photography, etc.)
School Clubs (Key Club, Kiwanis, Photography, etc.)
Junior ROTC
Junior ROTC
Band/Chorus/Theater
Band/Chorus/Theater
Student Government
Student Government
Girl Scouts
Girl Scouts
Boy Scouts
Boy Scouts
Church Youth Group
Church Youth Group
Other
19.
Overall, what type of grades do you usually get in school?
Mostly A's
Mostly A's
A's and B's
A's and B's
Mostly B's
Mostly B's
B's and C's
B's and C's
Mosty C's
Mosty C's
C's and D's
C's and D's
Mostly D's
Mostly D's
Failing
Failing