G.E.M. Prosper's Facilitator Pre Survey

Facilitator Pre-Survey

Hello G.E.M. Prosper Facilitator!We are so excited to have you partnered with our organization! In order to truly gage the impact of our program we ask that you as the facilitator of your G.E.M. Gather Group complete this form before your sessions start.

Thank you

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* 1. First and Last Name

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* 2. Please name the school/entity site where you are currently hosting G.E.M. Gather Groups

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* 3. Please share your work contact phone number

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* 4. Please provide the best email to contact you at

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* 5. Please share your current work profession

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* 6. Please share your highest level of education

Doctorate Degree

Masters Degree

Bachelor's Degree

High School Diploma

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* 7. Please share your ethnicity

White

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

Prefer not to say

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* 8. What is your goal in starting a G.E.M. Gather Group at your site?

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* 9. Have you used our G.E.M. Curriculum Vol. 1 before?

Yes

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* 10. What is your goal in utilizing the G.E.M. Curriculum and G.E.M. Teen Workbooks in your sessions?

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* 11. Please share your confidence in hosting a G.E.M. Gather Program at your site

Extremely confident

Very confident

Somewhat confident

Not so confident

Not at all confident