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* 1. What school do you attend

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* 2. What grade are you in?

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* 3. We are exploring options for opening a Teen Center in Richland. One of the models we are considering is a storefront location (such as the Uptown Shopping Center). What should we take into consideration when choosing a location for a Teen Center in Richland?

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* 4. Would there be any barriers for you to be able to attend a Teen Center after school?

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* 5. What programs or activities would you be interested in participating in? Choose as many as you'd like.

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* 6. Are there any needs in your life that the Club could help with?

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* 7. Anything else we should consider or would like us to know as we explore options for a teen program in Richland?

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* 8. If you would like to be entered into a drawing for a $100 gift card, please leave your contact information below. This information will not be used for any other purpose. Thank you for your time and input! 

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