The Salvation Army Boys & Girls Club of Charleston is planning to apply for a 21st Century Community Learning Center grant. Your responses to this survey will help us understand student and family needs and how an afterschool program can help address those needs.

* 1. What do you do afterschool?

* 2. Do you need help completing homework assignments afterschool?

* 3. If you attend an afterschool program, how often do you participate during the week?

* 4. If you do not attend an afterschool program, please select the reasons why.

* 5. How often do you participate in sports or physical activities (for more than 30 minutes)?

* 6. Have you ever witnessed, or have been subject to, bullying at your school?

* 7. Select the activities/services for an afterschool program that you feel are important.

* 8. Select the family activities/services you think members of your family would be interested in and/or willing to attend.

* 9. What would prevent your family from attending family engagement events?

* 10. Please provide three recommendations for services, partners, or activities that should be part of the afterschool program: