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1. What is your name?

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2. What grade are you in this year?

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3. What school are you currently attending?

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4. What prounouns do you use?

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5. Are you available on Tuesday and Thursday

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6. Are you comfortable working in a team?

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7. Tell us a little bit about what kind of chores you are responsible for at home (examples babysitting, lawn mowing, dish washing...)

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8. What hobbies or interests do you have? (Example: D and D, knitting, cooking)

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9. What are THREE words you would use to describe yourself?

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10. What is your favorite meal?

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11. What are some of your favorite places to visit

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12. Why are you interested in this program

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13. What is something you want to learn/need help with?

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14. What is a skill/talent you can offer to the group?

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15. Do you need help with homework?

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16. Do you need transportation to LCOC?

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17. Do you need transportation home?

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18. Please provide us with your parent(s) name, phone and email

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