1. BASICS

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* 1. Name:

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* 2. Estimated Family Income

  1-3 living in household 4-6 living in household 7-10 living in househlod 11+ living in household
below $20,000
$20,000 - $39,000
$40,000 - $75,000
above $75,000

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* 3. What do you believe your to be your key responsibilities?

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* 4. How long have you been involved with In Progress?

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* 5. I would rate my skills in the following as:

  poor needs improvement adequate good excellent
dependability
communication
commitment to In Progress
storytelling
artistic ability
collaboration
technical ability
creative thinking
troubleshooting skills
ability to lead others
ability to complete what I start

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* 6. Please rate your comfort level with the following:

  poor needs improvement adequate good excellent
being a team leader
working by myself
working as part of a team
taking directions from others
asking questions when I don't understand what I am supposed to do
having to make decisions
teaching others
critiquing others
accepting constructive criticism
accepting criticism from my supervisor
changing bad work habits

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* 7. I believe myself to be:

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* 8. My favorite work environment is where I am

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* 9. Please rate the following obstacles you face with your work with In Progress

  not an obstacle an obstacle I can manage a big obstacle
family responsiblities
transportation problems
lack of discipline
lack of interest
obligations to oher paid employment
obligations to other volunteer commitments
inability to work with others productively
lack of self confidence in meeting the challenge
lack of focus
lack of skill
unstable home environment
homelessness

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* 10. I believe that my service to In Progress will assist me in:

  I don't believe this It will help me some It will help me a lot
preparing for college
preparing for the work place
becoming a better artist
becoming a stronger leader
gaining recognition for my true abilities
understanding my potential with In Progress

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* 11. Next year, I hope to continue my relationship with In Progress by:

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* 12. I hope my future with In Progress will lead to:

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* 13. I would like to learn more about the following careers:

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* 14. Here are some ideas I have for possible activities, classes, field trips, fun etc.... that I would like to see happen at In Progress:

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