Question Title

* 1. Organization:

Question Title

* 2. Organization website:

Question Title

* 3. Program name (if applicable):

Question Title

* 4. Please provide a short description of your organization:

Question Title

* 5. Age of youth who will experience Respect 360 (select all that apply):

Question Title

* 6. How many youth will participate (approximate if exact number is unknown)?

Question Title

* 7. Select the kind setting or program in which you'll be using Respect 360:

Question Title

* 8. How often will you lead a Respect 360 session?

Question Title

* 9. How long will you meet during each session?

Question Title

* 10. If you have a set program cycle, how many Respect 360 activities do you plan to utilize?

Question Title

* 11. What outcomes do you want to achieve by integrating Respect 360 into your youth development framework?

Question Title

* 12. My definition of respect is:

Question Title

* 13. I model self-respect for youth/young adults by:

Question Title

* 14. Please select the choice that best describes how you feel about each of the following statements right now.

  Strongly Agree Agree Disagree Strongly Disagree
The Respect 360 orientation webinar was helpful in preparing me to use the toolkit.
I'm committed to practicing The Respect Basics for myself.
I can describe the difference between self-esteem and self-respect.
I understand how to effectively use the toolkit.
I'm confident I can lead Respect 360 activities after attending the webinar.
I need more training to effectively lead Respect 360 (add what additional support you'd like in comment box).

T