High School Student Survey (POST-Full Year)2012-2013

1.

Hi! Thank you for helping us with this survey. One activity that is very important is for us to get to know you. Below, we are going to ask you some questions and we would like you to answer them as best as you can. Don’t worry about other people knowing what you say. We do not share what you say to us today with anyone (even your teachers and school staff) except the mentoring program staff so that we can make the program as good as we can for you. If you have any questions, please feel free to ask the mentoring program person.

Please only mark one answer per question. There are no right or wrong answers and you are not graded or scored on this survey. We really appreciate your help!

Question Title

* 1. Tell us about yourself!

First name:

Last name:

Email Address:

Street Address (number and name):

City:

State:

Zip:

Home Phone (with area code):

Cell Phone (with area code):

Which teacher are you completing this with?

Question Title

* 2. What school do you attend?

Warren Mott High School

Community High School

Cass Technical High School

Harper Woods High School

Jalen Rose Leadership Academy

Madison High School

Pontiac High School

Question Title

* 3. Please provide contact information for the parent/guardian you live with:

First Name:

Last Name:

Work Phone (with area code):

Cell Phone (with area code)

33% of survey complete.