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* 2. How many years have you taught at this school?

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* 3. What is your position/role?

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* 4. During the last year, did you participate (teach, run programs) in the before/after school program at your school?

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* 5. If you answered no, please describe why you did not participate?

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* 6. After each statement, rate how your program is doing from "Excellent" to "I don't see this happening at our program."

  Excellent Pretty good Does this but not inspiring Could use more work in this area I don't see this happening in our program
There is something for everyone regardless of income level, race, ability, special needs, religion, or sexual orientation.
Offers programs or snacks that promote healthy lifestyles and a safe, and positive social environment.
Provides opportunities for academic support and success after high school.
Values student input about adding programs that reflect their interests.
Hires great staff who are positive and make students want to come to the program.
Provides hands on skills/activities to develop skills that students need for their future.
Offers engaging clubs and activities that expand students' options for jobs, careers, and college.

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* 7. Based on your observations of student engagement in your before/after school program, please rate the following:

  This is our routine, it works, and we can model it for others This is in place and we have evidence that it occurs This has recently started at our school Plans are in place to implement this at our school Our school has not yet started work in this area N/A
Students are actively engaged in exploring future options
Students have hands-on opportunities that result in a project or presentation
Students give feedback that staff use to develop relevant activities and clubs
Students participate in projects that have a social impact
Activities engage students in critical thinking and collaborative teamwork

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* 8. Based on your observations of supportive environments for students and staff in your before/after school program, please rate the following:

  This is our routine, it works, and we can model it for others This is in place and we have evidence that it occurs This has recently started at our school Plans are in place to implement this at our school Our school has not yet started work in this area
Students are actively engaged in programs that promote well-being and healthy choices and behaviors
Program environment supports students social-emotional health
Professional development is planned and is ongoing to support staff needs and growth
Staff listen to students and provide a welcoming atmosphere that promotes student attendance and growth
Program environment supports positive peer interactions

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* 9. Based on your observation of program management and improvement in your before/after school program, please rate the following:

  This is our routine, it works, and we can model it for others This is in place and we have evidence that it occurs This has recently started at our school Plans are in place to implement this at our school Our school has not yet started work in this area N/A
Data collected from multiple sources is used to improve practice and inform decisions
School leadership and staff engage stakeholders to increase program sustainability
Fiscal and program attendance is supported by sound policies and procedures reinforced with regular training
Collaboration with students, parents, teachers, and community exists to increase program relevance and offerings

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* 10. Based on your observations of inclusivity in your before/after school program, please rate the following:

  This is our routine, it works, and we can model it for others This is in place and we have evidence that it occurs This has recently started at our school Plans are in place to implement this at our school Our school has not yet started work in this area N/A
Program creates an environment that embraces values of inclusion, diversity, and equity
School leadership encourages integration between regular school and after school activities
Program mission and vision communicated with students, teachers, staff, and community partners
Communication between community, students, and parents informs mission and program goals
Listen to youth voice and provide opportunities for leadership

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* 11. Please share an important experience you have had during the last year in your before/after school program.

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* 12. Please share a specific experience of positive student engagement from your time teaching in the before/after school program this past school year.

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* 13. If you would you like to participate in a focus group to provide feedback on your before/after school program, please provide your email below.

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