2013 CCLC Student Questionnaire

1. Default Section

Question Title

* 1. Which school do you attend?

Independence High School

Provost Elementary

Rock Canyon Elementary

Sunset View Elementary

Timpanogos Elementary

Westridge Elementary

Question Title

* 2. What grade are you in?

3rd

4th

5th

6th

9th

10th

11th

12th

Question Title

* 3. Are you interested in attending a before or after school program?

Yes

No

Question Title

* 4. I would be interested in attending the following activities: (check all that apply)

Academic Enrichment

Math Tutoring

Writing Tutoring

Classes for High School Credit (Independence Only)

Other Academic Tutoring

Homework Help

English as a Second Language

Fitness Classes

Library

Tutoring

Art

Music

Dance

Science

Technology

Engineering

Underwater Robotic (Westridge Only)

Career Exploration

Financial Literacy

Service Learning

Gang Prevention

Technology

Leadership

Parent & Teen Communication

Other (please specify)