Kashia Youth Interest Assessment

To help Kashia Department of Environmental Planning (KDEP) develop environmental programs, activities and events that benefit and engage youth interests, please fill out the following assessment.

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* 1. What is your name?

First and Last Name

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* 2. What is your age?

Under 11 years

11-14 years

15-18 years

Over 18 years

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* 3. I would be interested in participating in the following events and activities (check all that apply)

Youth Environmental Internship Program w/ Kashia Department of Environmental Planning

Environmental Youth Campout on Kashia Coastal Reserve

Gathering/harvesting event collecting plant materials and/or marine resources

Environmental career exploration

Interpretive walks/hikes on Tribal lands (focus on traditional Kashia land practices/values)

Other (please specify)

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* 4. How interested are you in learning about the following topics?

	Not Interested	Somewhat Interested	Very Interested	No Opinion
Traditional Land Management and Fire Practices (cultural burning)	Traditional Land Management and Fire Practices (cultural burning) Not Interested	Traditional Land Management and Fire Practices (cultural burning) Somewhat Interested	Traditional Land Management and Fire Practices (cultural burning) Very Interested	Traditional Land Management and Fire Practices (cultural burning) No Opinion
Plant Identification	Plant Identification Not Interested	Plant Identification Somewhat Interested	Plant Identification Very Interested	Plant Identification No Opinion
Culturally Significant Plants and Traditional Foods	Culturally Significant Plants and Traditional Foods Not Interested	Culturally Significant Plants and Traditional Foods Somewhat Interested	Culturally Significant Plants and Traditional Foods Very Interested	Culturally Significant Plants and Traditional Foods No Opinion
Traditional Gathering Practices of Plants and/or Marine Resources	Traditional Gathering Practices of Plants and/or Marine Resources Not Interested	Traditional Gathering Practices of Plants and/or Marine Resources Somewhat Interested	Traditional Gathering Practices of Plants and/or Marine Resources Very Interested	Traditional Gathering Practices of Plants and/or Marine Resources No Opinion
Marine Resource Identification	Marine Resource Identification Not Interested	Marine Resource Identification Somewhat Interested	Marine Resource Identification Very Interested	Marine Resource Identification No Opinion
Climate Change Impacts and Adaptation	Climate Change Impacts and Adaptation Not Interested	Climate Change Impacts and Adaptation Somewhat Interested	Climate Change Impacts and Adaptation Very Interested	Climate Change Impacts and Adaptation No Opinion
Water Quality Monitoring and Sampling	Water Quality Monitoring and Sampling Not Interested	Water Quality Monitoring and Sampling Somewhat Interested	Water Quality Monitoring and Sampling Very Interested	Water Quality Monitoring and Sampling No Opinion

Other (please specify)

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* 5. Do you conduct any of the following outdoor activities with your family?

	Yes	No
Hiking	Hiking Yes	Hiking No
Camping	Camping Yes	Camping No
Gathering of culturally significant plants (basketry material, medicine, food)	Gathering of culturally significant plants (basketry material, medicine, food) Yes	Gathering of culturally significant plants (basketry material, medicine, food) No
Gathering of marine resources (fish, seaweed, mussels, etc)	Gathering of marine resources (fish, seaweed, mussels, etc) Yes	Gathering of marine resources (fish, seaweed, mussels, etc) No

If you answered yes to gathering of culturally significant plants or marine resources, please identify, if known, the types of resources collected (Huckleberries, acorns, seaweed, mussels, etc).

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* 6. Would you be interested in becoming involved in any of the following activites?

Assist in conducting interviews

Drawing/producing educational outreach materials on environmental topics (posters, pamphlets, brochures, etc)

Participate in monitoring surveys/collection of environmental data (coastal, water quality, wildlife…)

Assist KDEP guide environmental outreach tours on the Kashia Coastal Reserve

Other (please specify)

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* 7. If you would like to receive announcements about upcoming environmental outreach events and activities please provide your contact information below.

Address

City/Town

State/Province

ZIP/Postal Code

Email Address