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* 1. Where does your program/organization provide services? (What town?)

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* 2. What age group do you serve? (please check all that apply)

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* 3. What kinds of programming/activities do your currently offer? (please check all that apply)

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* 4. When does your program operate? (please check all that apply)

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* 5. Do you offer programming during school vacations?

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* 6. My community needs . . . (please check only one answer per row)

  Strongly Disagree Somewhat Disagree Somewhat Agree Strongly Agree Not Sure
More after-school activities during the academic year.
More program/activity options during the weekends.
More program/activity options during the summer.
More offerings for elementary-aged youth.
More offerings for middle-school aged youth.
More offerings for high-school aged youth.

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* 7. What do you think are the biggest challenges/issues facing youth in YOUR COMMUNITY right now? 

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* 8. What do you see as the biggest gaps in programs currently available to youth?

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* 9. How do you think additional resources for after-school programming would be best spent?

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* 10. What would you like to see incorporated into a state plan for expanded learning opportunities for children and youth? 

Thank you for your help! For the latest in everything afterschool in Connecticut, please visit our website at www.ctafterschoolnetwork.org.

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