Planning a Future Vision of Wellfleet Planning a Future Vision of Wellfleet “Have a say in the future of Wellfleet! Get money for activities and facilities! Wellfleet wants your voice to be heard in their planning for the future of the Town! For questions please contact Wellfleet Recreation Director, Becky Rosenberg atBecky.Rosenberg@wellfleet-ma.gov.” OK Question Title * 1. Please enter your age: OK Question Title * 2. Please enter your grade: OK Question Title * 3. Please enter your email address (Optional): OK Question Title * 4. Which of the following activities interests you (check all that apply): Job Internship Athletics Outdoor adventure activities College and Career planning Community Service Academic Other (please specify) OK Question Title * 5. Which types of jobs/internships would have the most interest to you (check all that apply) Service Fishing Landscaper Teacher Aquaculture Artist Musician Writer Chef Other (please specify) OK Question Title * 6. Which types of athletic activities interests you the most? Check all that apply: Swimming Basketball Soccer Football Bowling Ping-Pong Tennis Skateboarding Surfing Lacrosse Track and Field Exercise and Weight Lifting Baseball Other (please specify) OK Question Title * 7. Which types of Outdoor Adventure Interest you the most? Check all that apply: Biking Ropes Course Horseback Riding Hiking Other (please specify) OK Question Title * 8. Which College and Career planning activities interest you? Check all that apply: College Planning SAT Preparation College Application and Interview Preparation Career and Discovery Planning Other (please specify) OK Question Title * 9. Which Community Service activities interest you? Check all that apply: Community Service - Environment Community Service - Performing Arts Community Service - Teaching/Coaching Community Service - Healthcare Community Service - Visual Arts OK Question Title * 10. Which of the following academic activities interest you? Check all that apply: Poetry Math Creative Writing Psychology Computer Programming History Other (please specify) OK Question Title * 11. Please select the activities you are interested in as a youth center program. Please add any other suggestions you have in the space below: Art Classes Volunteer Opportunities/Internships Cooking Classes Contests Movie Nights Coding Pool/Ping Pong Book Club Teen Only Party Paid Performer 3D Printing Drama (writing, directing, set and costume making) Tutoring younger children Other (please specify) OK Question Title * 12. Please select from below the days/times you would most use a youth center. Check all that apply: Monday Tuesday Wednesday Thursday Friday Saturday Sunday Late afternoons Evenings School Vacations OK Question Title * 13. Please select all the social networking sites you use: Blogger Facebook Twitter MySpace Instagram I don't use Social Networking sites Other (please specify) OK Question Title * 14. Please list any activities you do during non-school hours: OK Question Title * 15. If there was a youth center email list would you like to be added? Yes No OK Question Title * 16. Would you like a reminder about a teen program emailed to you the day before? Yes No OK Question Title * 17. Please add any additional suggestions or comments here: OK Question Title * 18. Would you like to be part of a teen advisory board? If so kindly enter your contact information below. Yes No Contact Information: OK DONE