1. 21st CCLC Student Survey - Egg Harbor City

PURPOSE: The purpose of this survey is to obtain your feelings about the implementation and impact of the 21st Century Community Learning Centers (21st CCLC) in which you are participating. Your opinions will be used to improve future program activities.

DIRECTIONS: Respond to each item by checking the box which most accurately describes you.

The name of my site is:

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1. The name of my site is:

The grade I am in is:

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2. The grade I am in is:

Do you participate in any other after-school programs?

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3. Do you participate in any other after-school programs?

How would you rate your familiarity with the goals and objectives of the 21st CCLC program?

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4. How would you rate your familiarity with the goals and objectives of the 21st CCLC program?

How would you rate your attitude toward school as a result of participation in the 21st CCLC program?

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5. How would you rate your attitude toward school as a result of participation in the 21st CCLC program?

How would you rate your self-esteem as a result of participation in the 21st CCLC program?

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6. How would you rate your self-esteem as a result of participation in the 21st CCLC program?

How would you rate your social behavior as a result of participation in the 21st CCLC program?

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7. How would you rate your social behavior as a result of participation in the 21st CCLC program?

How would you rate your discipline behavior as a result of participation in the 21st CCLC program?

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8. How would you rate your discipline behavior as a result of participation in the 21st CCLC program?

How would you rate your academic achievement as a result of their participation in the 21st CCLC program?

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9. How would you rate your academic achievement as a result of their participation in the 21st CCLC program?

How would you rate the overall impact of the 21st CCLC program?

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10. How would you rate the overall impact of the 21st CCLC program?

What are the strengths of the 21st CCLC program?

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11. What are the strengths of the 21st CCLC program?

What are the weaknesses of the 21st CCLC program?

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12. What are the weaknesses of the 21st CCLC program?

What changes would you suggest to improve the 21st CCLC program?

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13. What changes would you suggest to improve the 21st CCLC program?

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