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* 1. Please write your ID code in the space below.

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* 2. How do you think the school and community organizations you are involved in affect your life in the following areas? (1-postive, 7-negative)

  1 2 3 4 5 6 7

Academics

Personal Life
Social Life
Health
Self-Esteem

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* 3. After I Graduate High School

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* 4. How much do you agree? (1-Strongly Agree, 5-Strongly Disagree)

  Strongly Agree Agree No opinion Disagree Strongly Disagree
Student organizations are important in having a good high school education and experience
Serving others is a responsibility of leadership
Understanding my community is an important part of leadership
I can identify inequalities that exist in my community
I have a voice in the decisions in my community
I know how to make positive changes in my community
I believe I have an ethical responsibility to make changes in my community
I know how to work with people I'm serving to make sure our both needs are met
It's important to avoid conflict in a group
I know how to help groups I work with set clear goals for what we want to accomplish
I know how to help groups work well as a team
I know how to communicate with members of my group
I believe my group should have one leader that always makes sure we reach our goals
I'm comfortable supporting others in my group and recognizing their achievements
I'm comfortable collaborating with teachers and other adults
I'm comfortable involving different people with different backgrounds in our group
I'm comfortable resolving conflicts in the groups I work with
I'm comfortable giving feedback to other members in my group, in a positive and helpful manner

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* 5. How comfortable are you with the following items? 1=Very Comfortable 5=Don't know how to do this

  I know how to do this and am very comfortable doing this right now I know how to do this and am comfortable doing this right now No opinion I know how to do this but I am not comfortable doing this right now I do not know how to do this
I can describe my leadership style
I can identify my personal values
I can explain how my personal values relate to my leadership style
I can seek out leadership training opportunities 
I can explain how or when I decide to stick to values, and when I am willing to compromise
I can identify my comfort level with taking risks
I can accept my mistakes
I can ask for help when I need it
I accept feedback on my abilities and actions from my group
I accept feedback on my opinions and beliefs from my group

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* 6.  What did you like best? What would you change?  How much did this help?(1=Very Helpful 5=Not Helpful)

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* 7. What were your favorite parts of camp, and why?

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* 8. What changes would you make to make camp better?

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* 9. Overall Experience at MIYLT?

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* 10. Any other thoughts or comments?

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