After School Program Student Survey

PURPOSE: The purpose of this survey is to obtain your feelings about the implementation and impact of the After School Program in which you are participating. Your opinions will be used to improve future program activities.

DIRECTIONS: Respond to each item by checking the box which most accurately describes you.

1. The name of my site is:

2. The grade I am in is:

3. Do you participate in any other after-school programs?

4. How would you rate your understanding of the purpose of the After School Program?

5. How would you rate your attitude toward school as a result of your participation in the After School Program?

6. How would you rate your self-esteem as a result of your participation in the After School Program?

7. How would you rate your academic achievement (grades in school/report card), as a result of your participation in the After School Program?

8. How would you rate your overall experience as a student in the After School Program?

9. As a result of your participation in the dinner program, how did you improve in each of the following areas? (Select one response for each item)

  Improved a Lot Improved a Little Did not Improve Don't Know or Not Sure
Grades
Attitude toward school
Overall attendance at school
Being on time for school
General health and well being
Alertness
Paying attention in class
Ability to get along with peers
Study habits/study skills
Completing homework assignments
General disciplinary behaviors
Participation in regular school-day activities
Participation in after school activitiesSelf-confidence
Problem-solving skills
Critical thinking skills

10. What is your overall opinion of the following food service programs offered in the district?

  Excellent Good Fair Poor
Breakfast
Lunch
Dinner

11. Please offer any comments about the food service programs offered in the district.

12. What are the strengths of the After School Program?

13. What are the weaknesses of the After School Program?

14. What changes would you suggest to improve the After School Program?

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