1. **POST** Data Entry

Data entry instructions - Please assign a unique number to EACH completed survey record before beginning. This will assist us if we need to track a particular answer to the original survey.

In addition, you may notice that your region's version of the survey may not ask an item. If your region's participants have not been asked about an item or if it is blank, just leave the response blank.

Please verify that this is NOT a "Pre" survey.

Thank you!

* Survey ID#

* Age level:

* Grade

* Date (Please use numbers. November 12, 2008 = 11/12/2008)

(This is the date that the participant responded to the survey.)

Today's date

* Middle Initial, Favorite animal? (compares pre/post)

* Region

* Pre? or Post? (All should be POST.)

* Type of Series?

* County (Data entry: Please enter the county where the meeting place is located.)

* Special funder or grant?
If yes, please describe. (See list below.)

Ask staff if you don't know.

* How often do you …?

  1 Never 2 Hardly ever 3 Sometimes 4 A lot of the time 5 Always ? Not sure or don't want to say
When I am with younger kids, I set a good example by choosing healthy snacks (like fruits and vegetables). @post
I like to try new things, even if I might not do too well at first.@post
I set goals for myself to achieve. @post
Before I make a final decision, I think about all of my options. @post
I work well with others as a team. @post
When I read or hear about other people’s problems, I think of ways I can help. @post
I ask others for help when I need it. @post
When I see someone being picked on, I try to help. @post
I speak up for what is right, even if it is not popular.@post

* How much do you AGREE...

  1 Disagree a lot 2 Disagree a little 3 Agree a little 4 Agree a lot ? Not sure or don't want to say
To make others like me, I sometimes do things that I know are wrong. @pre
I try to talk problems out calmly instead of yelling. @post
I really like who I am, no matter what other people think. @post (optional-Dayton use)
I think that learning new things is always fun. @post (optional- Toledo use)

* How much LIKE YOU is...?

  1 Not at all like me 2 Not much like me 3 A little like me 4 A lot like me ? Not sure or don't want to say
I like being a girl.@post
If I get into an argument with friends, I am able to think of more than one way to make things better.@post
I look for ways to meet kids who are from cultures different than mine.@post
I am able to get others to take action when a problem arises in my community.@post

* Have you felt welcomed by adults to GS activities?

* Have you participated in Girl Scout activities before?

* I can't wait to (@post) " ____________________"

* In this Girl Scout experience, I was able to do things I could not do in other places.

* What makes you feel best about GS program activities?

* What could we do to make the program activities better?

* What could be done to make things better?

* WHO is the adult with you at GS activities?

* Would you participate again in GS activities?

* Would you recommend GS activities to a friend?

* [required in Cincinnati- enter other regions' data if provided]
In each week, how many weekdays (Mon-Fri) are you involved in activities such as GS, sports, clubs, other organizations or lessons in "after-school hours" before 6pm?

* Other comments...

* Work Order# ("336-_ _ _ - r _ _")

Thank you.