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* 1. What is your first name?

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* 2. What is your last name?

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* 4. Are you currently involved in any type of organized club or team? (Select all that apply.)

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* 5. The biggest thing that keeps you from being involved in a team or club is (select all that apply):

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* 6. Please choose the top 3 activities you would be interested in being involved with if they were offered after school:

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* 7. If you were involved in an after school activity for 6 weeks how long do you think each session should last?

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* 8. Do you have any ideas on what we could name this after school program (the overall name, not just the name for a certain club) or how we could make it successful?

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