Middlesex YMCA Teen Survey
RequiredRequired Question(s)
Please take some time to fill out our teen survey so the Middlesex Y can learn how to better serve teens in the Northern Middlesex community. We appreciate your participation and will use the information you provide to enhance our teen programs and outreach. The Teen Coordinator may contact you via e-mail regarding potential programs you've shown interest in. Thank you for taking our survey.
 
Required 1.

How old are you?  

13
14
15
16
17
18
19
Required 2.

The Northern Middlesex YMCA services the following towns/cities. Which of these towns/cities do you live in? 

Middletown
Portland
Cromwell
East Haddam
Durham/Middlefield
East Hampton
Other  
Required 3.

How often did you visit the Y?  

Less than once a month.
Twice a month.
Once a week.
A few times a week.
Required 4.

What best describes your gender? Male? Female? I identify as..... 

 

50 characters left.
Required 5.
What best describes your cultural / ethnic identity? Check all that may apply. 
Asian
Black (African American)
Hispanic / Latinx
Native American
White
Other  
Required 6.

Where do you get information about what is happening in your community? Be specific as possible.  

 

50 characters left.
7.

Would you be interested in participating in a teen leadership program at the Y? 

Yes
No
Maybe
Required 8.
Would you be interested in participating in a music appreciation program at the Y? 
Yes
No
Maybe
Required 9.

Would you be interested in participating in a Y Teen Newsletter Team?  

Yes
No
Maybe
Required 10.

Would you be interested in participating in a Y Teen Poetry Corner Team? 

Yes
No
Maybe
Required 11.

Would you be interested in participating in a Y Teen Chess/Checkers Club?  

Yes
No
Maybe
Required 12.

Would you be interested in participating in a Y Teen Community Helpers Club? 

Yes
No
Maybe
Required 13.

Would you be interested in participating in trainings for life skills and personal development? 

Yes
No
Maybe
Required 14.

Would you be interested in participating in teen arts and crafts projects?  

Yes
No
Maybe
Required 15.

Would you be interested in participating in teen fitness classes/programs?   

Yes
No
Maybe