Dear Student, 

We need your help! Your feedback is very important. This survey is confidential - your individual answers will not be shared with anyone. All data will be aggregated and de-identified before it is shared with others.

Question Title

* 1. What is your first name?

Question Title

* 2. What is your last name?

Question Title

* 3. What is your student ID number?

Question Title

* 4. What is your teacher's name?

Question Title

* 5. What grade are you in?

Question Title

* 6. What is your gender?

Question Title

* 7. Is English your first language?

Question Title

* 8. What city/town do you live in?

Question Title

* 9. What school do you attend?

Question Title

* 10. Please indicate your three favorite subjects. (Please check all three.)

Question Title

* 11. Have you ever...

  Yes  N0
seen a professional dance performance?
participated in a dance?
performed in front of a live audience?
learned something new from watching dance?
learned something new from dance activities?
learned dance vocabulary?

Question Title

* 12. Please tell us whether you AGREE or DISAGREE with the following statements.

  Strongly Agree Agree Neither Agree or Disagree Disagree Strongly Disagree
I like to create things.
I like new experiences.
I like to try new things. 
I feel good about myself.
I am not afraid of making mistakes. 
When I set a goal I do not give up.
I am very creative.
I am very interested in the arts (dance, music, theater, visual arts, and/or media arts).
I am very interested in dance.
I care how others are feeling.
I listen to others.
I am interested in learning about people from a different background.
I can learn from people from a different background.
People listen to what I have to say.
Expressing my thoughts is important to me.
I think of myself as an artist.

Question Title

* 13. How often do you...

  Always Most of the time Sometimes Rarely Never
change something you have worked on to make it better?
use dance to tell a story?
talk to your parents about what you are doing in school?
use your imagination?

Question Title

* 14. Please tell us whether you AGREE or DISAGREE with the following statements.

  Strongly Agree Agree Neither Agree or Disagree Disagree Strongly Disagree
I enjoy going to school. 
I have a connection with my teacher(s).
I complete my homework. 
I like to participate in class.
I am proud of my work in school. 
I have good study skills.
I enjoy learning.
My attendance at school is good. 
I am focused in class. 
My teacher(s) cares about me. 

Question Title

* 15. Check the words that best describe you. (Please check all that apply.)

Question Title

* 16. What do you do during your free time? (Please check all that apply)

Question Title

* 17. Are either of your parents/guardians a professional artist? (Actor, Dancer, Designer, Musician, Painter, Photographer, Writer, etc...) Yes No

Question Title

* 18. Please tell us if your parents/guardians do any of the following activities for fun. (Check all that apply.)

Question Title

* 19. Please tell us if you have ever been to the following. (Check all that apply.)

Question Title

* 20. Please answer the following questions with either a "Yes" or a "No".

  Yes No
Do you think the skills you use to make music and write are similar to each other?
Do you think the skills you use to make music and do math are similar to each other?
Do you think the skills you use to draw/paint and write are similar to each other?
Do you think the skills you use to draw/paint and do math are similar to each other?
Do you think the skills you use to dance and do science are similar to each other?
Do you think the skills you use to act and to write are similar to each other?

Question Title

* 21. Please answer the following questions with either a "Yes" or a "No".

  Yes No
Do you use your imagination the same when you draw/paint as when you write?
Do you use your imagination the same when you draw/paint as when you do math?
Do you use your imagination the same when you make music as when you write?
Do you use your imagination the same when you make music as when you do math?
Do you use your imagination the same when you dance as when you write?
Do you use your imagination the same when you sing as when you do science?
Do you use your imagination the same when you dance as when you do science?

Question Title

* 22. What has been the most interesting thing that you have done in school?

Question Title

* 23. Please tell us whether you AGREE or DISAGREE with the following statements.

  Strongly Agree Agree Neither Agree or Disagree Disagree Strongly Disagree
I enjoyed this experience.
This experience made me think of myself more positively.
This experience made me think in new ways.
I made new friends through this experience.
Through this experience I learned about people who are different than me. 
This program made me more interested in the arts.
This program made me more interested in dance.
I want to attend another program like this.

Question Title

* 24. Please tell us what you liked most about this program.

Question Title

* 25. Please tell us how satisfied you were with this program.

Question Title

* 26. This experience makes me want to: (Please check all that apply.)

T