We would like to have feedback from YOU. This information will help us understand a bit more about you and help us to improve the program.

* 1. Test Type

* 2. What school do you attend?

* 3. What is your name?

* 4. What is your Student Identification Number?

* 5. What is today's date?

Date
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* 6. Instructions: Please select the answer that best represents how you think and feel.

  Strongly Disagree Disagree Unsure Agree Strongly Agree
A. I do creative work outside of this program (writing, drawing, dancing, playing music, etc.)
B. I look at the creative work of my friends and talk with them about it.
C. I see myself as an Artist (this includes being a Dancer or Actor, Musician, Filmmaker, etc.)
D. I use my culture and roots as inspiration for my art.
E. I think about performing or presenting my work for others to see.
F. I like to use my creative skills to connect with others.
G. I use the arts to communicate feelings and meaning.
H. I feel excited and focused when I am creating art.
I. I am able to express who I am through the arts.

* 7. Looking at the above items. What item (A-I) have you improved in the most and how?

* 8. What arts activity or projects have you participated in?

* 9. What is your age today?

* 10. What grade are you in?

* 11. Are you a boy or girl?

* 12. How do you describe yourself?

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