Youthtown Papakura T4 2012 Survey

Youthtown want to know what YOU are interested in doing! We design programmes based on your interests, so let us know what you would like to do and we will try and put it together for you! Answer this survey HONESTLY and you will be in the draw to win westfield vouchers and Youthtown Vouchers!!

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1. To be eligible for the prizes, you must complete all questions accurately and provide contact details (so we can call you if you win!). Youthtown will not disclose these details in any circumstances, but may use them to let you know of upcomming programmes and events

To be eligible for the prizes, you must complete all questions accurately and provide contact details (so we can call you if you win!). Youthtown will not disclose these details in any circumstances, but may use them to let you know of upcomming programmes and events First Name:
Surname
City/Town:
Phone Number:
Mobile Number:
Email Address:

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2. Gender

Gender Male

Female

3. School Year?

School Year? 7

4. Age?

Age? 10

5. School?

School? Rosehill Intermiate

Mansell Senior

Ed Hilary

Drury

Karaka

Tehihi

Ramarama

Papakura South

Takanini

6. Have you particacipated in a Youthtown Programme Before?

Have you particacipated in a Youthtown Programme Before? Coaching in Schools Programme

Holiday Programme

Break Away Programme

The following are examples of programmes we could offer to you. Please let us know what would interest you and we will try and make it happen!!
1 is NOT INTERESTED and 5 is VERY INTERESTED

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7. After School Programmes:

	1	2	3	4	5
Indoor Cricket	*After School Programmes: Indoor Cricket 1	Indoor Cricket 2	Indoor Cricket 3	Indoor Cricket 4	Indoor Cricket 5
Mountain Biking	Mountain Biking 1	Mountain Biking 2	Mountain Biking 3	Mountain Biking 4	Mountain Biking 5
Outdoor Rock Climbing	Outdoor Rock Climbing 1	Outdoor Rock Climbing 2	Outdoor Rock Climbing 3	Outdoor Rock Climbing 4	Outdoor Rock Climbing 5
Indoor Rock Climbing	Indoor Rock Climbing 1	Indoor Rock Climbing 2	Indoor Rock Climbing 3	Indoor Rock Climbing 4	Indoor Rock Climbing 5
Outdoor Rock Climbing	Outdoor Rock Climbing 1	Outdoor Rock Climbing 2	Outdoor Rock Climbing 3	Outdoor Rock Climbing 4	Outdoor Rock Climbing 5
Indoor Rock Climbing	Indoor Rock Climbing 1	Indoor Rock Climbing 2	Indoor Rock Climbing 3	Indoor Rock Climbing 4	Indoor Rock Climbing 5
Volleyball	Volleyball 1	Volleyball 2	Volleyball 3	Volleyball 4	Volleyball 5
Horse Riding	Horse Riding 1	Horse Riding 2	Horse Riding 3	Horse Riding 4	Horse Riding 5
Abseiling	Abseiling 1	Abseiling 2	Abseiling 3	Abseiling 4	Abseiling 5
Golf	Golf 1	Golf 2	Golf 3	Golf 4	Golf 5
Water Polo	Water Polo 1	Water Polo 2	Water Polo 3	Water Polo 4	Water Polo 5
Fitness	Fitness 1	Fitness 2	Fitness 3	Fitness 4	Fitness 5
Indoor Netball	Indoor Netball 1	Indoor Netball 2	Indoor Netball 3	Indoor Netball 4	Indoor Netball 5
Indoor Soccer	Indoor Soccer 1	Indoor Soccer 2	Indoor Soccer 3	Indoor Soccer 4	Indoor Soccer 5
Indoor Touch Rugby	Indoor Touch Rugby 1	Indoor Touch Rugby 2	Indoor Touch Rugby 3	Indoor Touch Rugby 4	Indoor Touch Rugby 5
Art programmes	Art programmes 1	Art programmes 2	Art programmes 3	Art programmes 4	Art programmes 5
Cooking	Cooking 1	Cooking 2	Cooking 3	Cooking 4	Cooking 5
Cake making	Cake making 1	Cake making 2	Cake making 3	Cake making 4	Cake making 5
Hip Hop	Hip Hop 1	Hip Hop 2	Hip Hop 3	Hip Hop 4	Hip Hop 5
Zumba	Zumba 1	Zumba 2	Zumba 3	Zumba 4	Zumba 5
Drama / acting	Drama / acting 1	Drama / acting 2	Drama / acting 3	Drama / acting 4	Drama / acting 5
Singing	Singing 1	Singing 2	Singing 3	Singing 4	Singing 5
Short Film / editing	Short Film / editing 1	Short Film / editing 2	Short Film / editing 3	Short Film / editing 4	Short Film / editing 5
Photography	Photography 1	Photography 2	Photography 3	Photography 4	Photography 5
Annimation	Annimation 1	Annimation 2	Annimation 3	Annimation 4	Annimation 5
Bush Skills	Bush Skills 1	Bush Skills 2	Bush Skills 3	Bush Skills 4	Bush Skills 5
Painting	Painting 1	Painting 2	Painting 3	Painting 4	Painting 5
Pottery	Pottery 1	Pottery 2	Pottery 3	Pottery 4	Pottery 5
Graffiti Art	Graffiti Art 1	Graffiti Art 2	Graffiti Art 3	Graffiti Art 4	Graffiti Art 5
self defence	self defence 1	self defence 2	self defence 3	self defence 4	self defence 5
Skate boarding	Skate boarding 1	Skate boarding 2	Skate boarding 3	Skate boarding 4	Skate boarding 5
BMX	BMX 1	BMX 2	BMX 3	BMX 4	BMX 5
Swimming	Swimming 1	Swimming 2	Swimming 3	Swimming 4	Swimming 5
Water Sports	Water Sports 1	Water Sports 2	Water Sports 3	Water Sports 4	Water Sports 5
Gardening	Gardening 1	Gardening 2	Gardening 3	Gardening 4	Gardening 5
Table Tennis	Table Tennis 1	Table Tennis 2	Table Tennis 3	Table Tennis 4	Table Tennis 5
Basket Ball	Basket Ball 1	Basket Ball 2	Basket Ball 3	Basket Ball 4	Basket Ball 5
Make-up & Haircare	Make-up & Haircare 1	Make-up & Haircare 2	Make-up & Haircare 3	Make-up & Haircare 4	Make-up & Haircare 5
Archery	Archery 1	Archery 2	Archery 3	Archery 4	Archery 5
Boxing	Boxing 1	Boxing 2	Boxing 3	Boxing 4	Boxing 5
Music Production	Music Production 1	Music Production 2	Music Production 3	Music Production 4	Music Production 5
Sculpture	Sculpture 1	Sculpture 2	Sculpture 3	Sculpture 4	Sculpture 5
Gymnastics	Gymnastics 1	Gymnastics 2	Gymnastics 3	Gymnastics 4	Gymnastics 5
Floristry	Floristry 1	Floristry 2	Floristry 3	Floristry 4	Floristry 5

8. What other after school work shops would interest you?

What other after school work shops would interest you?

9. What other Workshops would interest you?

What other Workshops would interest you?

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10. School Holiday Programmes:

	1	2	3	4	5
Mountain Biking	*School Holiday Programmes: Mountain Biking 1	Mountain Biking 2	Mountain Biking 3	Mountain Biking 4	Mountain Biking 5
Fishing	Fishing 1	Fishing 2	Fishing 3	Fishing 4	Fishing 5
Outdoor Climbing	Outdoor Climbing 1	Outdoor Climbing 2	Outdoor Climbing 3	Outdoor Climbing 4	Outdoor Climbing 5
Snowboarding	Snowboarding 1	Snowboarding 2	Snowboarding 3	Snowboarding 4	Snowboarding 5
Skiiing	Skiiing 1	Skiiing 2	Skiiing 3	Skiiing 4	Skiiing 5
Horse Riding	Horse Riding 1	Horse Riding 2	Horse Riding 3	Horse Riding 4	Horse Riding 5
Abseiling	Abseiling 1	Abseiling 2	Abseiling 3	Abseiling 4	Abseiling 5
Surfing	Surfing 1	Surfing 2	Surfing 3	Surfing 4	Surfing 5
Camping	Camping 1	Camping 2	Camping 3	Camping 4	Camping 5
Tramping - 1 day	Tramping - 1 day 1	Tramping - 1 day 2	Tramping - 1 day 3	Tramping - 1 day 4	Tramping - 1 day 5
Tramping - Multiple Days	Tramping - Multiple Days 1	Tramping - Multiple Days 2	Tramping - Multiple Days 3	Tramping - Multiple Days 4	Tramping - Multiple Days 5

11. What else would you want to do in the holidays that we could put together?

What else would you want to do in the holidays that we could put together?

Youthtown Papakura T4 2012

1.

*1. To be eligible for the prizes, you must complete all questions accurately and provide contact details (so we can call you if you win!). Youthtown will not disclose these details in any circumstances, but may use them to let you know of upcomming programmes and events

*2. Gender