Cheshire Youth Services Needs and Facility Assessment Survey

This survey is intended for youth to answer each question to provide their valuable feedback.  Please take a few minutes to fill out this survey to help Cheshire Youth Services gain a better understanding of what activities and programs are of interest to you.  This helps us plan seasonal activities that YOU want to do.

By completing this survey you will also help to identify ways in which we might improve and expand our Yellow House facility to better meet the needs of the youth in the community.

Your opinion is valued by our department, so please be honest and tell us what you think. Please also include your ideas, suggestions and comments when asked.

PARENTS: Some children may need help answering the questions. 

Thank you.
Cheshire Youth Services

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* 1. What grade are you in?

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* 2. How old are you?

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* 3. What school do you attend?

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* 4. How involved in the community and with activities do you feel you ARE CURRENTLY? (rate on a scale from 1-5, 1 = Extremely Active and 5 = Not Active at All)

  Extremely Active Active Somewhat Active Occasionally Not Active at All
How Involved Currently?

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* 5. How involved in the community and activities would you LIKE TO BE?  (rate on a scale from 1 - 5, 1 = Extremely Active and 5 = Not Active at All)

  Extremely Active Active Somewhat Active Occasionally Active Not Active at All
How involved do you want to be?

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* 6. What Cheshire Youth Services & Yellow House programs/activities have you been a part of? (check all that apply)

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* 7. Many students participate in extra-curricular activities.  Please indicate what types of activities you participate in, if any. (check all that apply)

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* 8. What is the MOST important thing about a club/activity you decide to participate in? (please rank in order of your priority (1 = most important / 2 = second most important and so on, 7 = not important at all).  If you are not in a club or activity rank "Not Applicable" = 1

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* 9. Which of the following do YOU think is the MOST important issue to young people? (1 = the Most Important and 6 = Not Important at all)

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* 10. What services are MOST important to YOU?  (please order in priority (e.g. 1 = MOST important, 2 = second most important and so on, 8 = not important at all)

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* 11. Do you prefer activities/groups that are:

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* 12. What would MOST prohibit you from attending a youth club or activity? (check the 2 that would most affect your decision)

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* 13. In your own words: Give reasons why you would not/could not participate in activities for youth.

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* 14. On the WEEKENDS when are YOU usually free and looking for something fun to fill your time?  (select all that apply)

  Mornings 10:00am-1:00pm Afternoons 2:00-5:00pm Evenings 6:00-9:00pm I am usually VERY BUSY this day I'm usually FREE ALL DAY
Friday
Saturday
Sunday

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* 15. Where do YOU spend MOST of your free time / recreational time?  (check all that apply)

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* 16. Tweens (5th-7th gr.):  What days/times of the week do YOU think are BEST for TWEEN groups/activities? please select all that apply.  (if you are not in gr. 5th-7th please select the last option for each day.)

  After School 3:00-5:30pm Evening 6:00-8:00pm I am Not currently in 5th-7th Gr.
Monday
Tuesday
Wednesday
Thursday
Friday

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* 17. Teens (8th-12th gr.):  What days/times of the week do YOU think are the BEST for TEEN clubs/programs?  Check all that apply (if you are not in gr. 8th-12th please select the last option for each day).

  After School 2:30-5:30pm Evenings 6:00-8:00pm I am NOT currently in 8th-12th gr.
Monday
Tuesday
Wednesday
Thursday
Friday

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* 18. Please read the following list and check off all the SKILL DEVELOPMENT activities that interest YOU:

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* 19. Please read the following list and check off all the ART/MUSIC activities that interest YOU:

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* 20. Please read the following list and check off all the GENERAL activities you would participate in:

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* 21. Please read the following list and check off all the OUTDOOR ACTIVITIES that interest YOU:

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* 22. Please read the following list and check off all the INDOOR activities that interest YOU:

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* 23. In addition to seasonal and weekly events, what special events or clubs might YOU like to see offered? check all that you might be interested in and ADD YOUR ideas in the "other" box below...

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* 24. Which types of FIELD TRIPS interest YOU? check all that apply.

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* 25. Youth Services is trying to gauge what types of things Cheshire youth would want at a youth facility/teen center. 
From the list below pick the TOP 5 things YOU would like and use the MOST:

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* 26. In your own words describe the TOP 3 things YOU would like to see at a youth facility.   This could be anything and does not have to be included in the list above.

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* 27. When would YOU use a youth center/facility the most?

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* 28. During the SCHOOL YEAR I would most likely use a youth facility/center during:

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* 29. During the SUMMER I would most likely use a youth facility/center during:

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* 30. Which of the following activities would YOU like to see at a youth facility? check all that apply.

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* 31. select the statement that BEST describes how YOU FEEL about a youth facility/center in Cheshire.

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* 32. How often do you think you would come to a youth facility/teen center that had all the services and activities that interest YOU?

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* 33. Which of the following statements do you agree with the most?

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* 34. What is the BEST way to communicate what is happening to youth in Cheshire? (check all that apply)

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* 35. On the topic of a youth center/facility, please share any additional ideas, comments or concerns that you may have here...

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* 36. On the topic of programs, services and groups that you feel are important to offer youth in the community please add any additional ideas, comments, or concerns you have here...

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