Project Name and Date

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* 1. Project Name and Date

In the box below write the FIRST letter of your first name and the FIRST letter of your middle name. If you do not have a middle name, write the first letter of your last name. So if your name is Maria Elena Jones, you would write M.E. in the box below.

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* 2. In the box below write the FIRST letter of your first name and the FIRST letter of your middle name. If you do not have a middle name, write the first letter of your last name. So if your name is Maria Elena Jones, you would write M.E. in the box below.

What is your gender?

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* 3. What is your gender?

What is the day of your birthday? If you were born October 10, you would write "10" in the box below.

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* 4. What is the day of your birthday? If you were born October 10, you would write "10" in the box below.

What grade are you in?

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* 5. What grade are you in?

What is your School?

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* 6. What is your School?

How would you describe yourself?

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* 7. How would you describe yourself?

What language do you speak the most at home?

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* 8. What language do you speak the most at home?

Are you able to get free or reduced-price lunch from your school right now?

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* 9. Are you able to get free or reduced-price lunch from your school right now?

Who lives at home with you right now?

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* 10. Who lives at home with you right now?

How many other kids are living in your house right now?

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* 11. How many other kids are living in your house right now?

Is there an adult in your house that has been to college or is going to college?

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* 12. Is there an adult in your house that has been to college or is going to college?

Has your Mother graduated from college?

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* 13. Has your Mother graduated from college?

Has your Father graduated from college?

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* 14. Has your Father graduated from college?

Does one of your parents currently have a job?

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* 15. Does one of your parents currently have a job?

Describe a job your parent's have right now or the last job they had.

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* 16. Describe a job your parent's have right now or the last job they had.

Do you currently work a job for pay?

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* 17. Do you currently work a job for pay?

Since the beginning of this semester, how many times have you been absent?

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* 18. Since the beginning of this semester, how many times have you been absent?

What grades did you make on your last report card?

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* 19. What grades did you make on your last report card?

Since the beginning of the semester how often do you...

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* 20. Since the beginning of the semester how often do you...

  Every day Most days of the week A few days out of the week never
Finish all your homework before class?
Get to your classes on time?
Bring all the needed materials to class?
Do you study for tests and quizzes ahead of time?

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* 21. Do you study for tests and quizzes ahead of time?

How often are the following statements true

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* 22. How often are the following statements true

  Always Sometimes Rarely
I take pride in the quality of my school work
School is fun and I like going to school
I give up when school is difficult 
I have no problems completing my school work 
I enjoy participating in my classes
I put forth a great deal of effort when doing my school work 
I have a hard time paying attention in class 
How well do the following statements describe you?

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* 23. How well do the following statements describe you?

  Exactly like me A little like me Not like me at all 
I like to imagine new ways to do things
I like to do things that are challenging
If I think I am going to fail, I won't try something
Making good grades is important to me
I try to learn as much as I can and don't care how long it takes
I am interested in what we learn in school 
Please tell us how often the following statements are true...

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* 24. Please tell us how often the following statements are true...

  Always Sometimes Rarely
If something interests me, I try to learn more
If am stuck on something, I will not stop until I find a solution
When I fail at something, I don't like to try again
How well do the following statements describe you?

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* 25. How well do the following statements describe you?

  Exactly like me A little like me Not like me at all 
I see myself as a leader
Other students see me as a leader
I think about others' feelings when I make a decision 
Please tell us how often the following statements are true...

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* 26. Please tell us how often the following statements are true...

  Always Sometimes Rarely
I feel comfortable speaking in front a group of people
I feel nervous when I have to speak with adults
It is easy for me to talk on the phone with people I don't know
How likely is it that you will do each of the following?

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* 27. How likely is it that you will do each of the following?

  Likely  Unlikely  I don't know
Get a job after highshcool
Attend a technical or trade school
Serve in the armed forces
Graduate from a 2-year college
Graduate from a 4-year college
Attend graduate or professional school after college
Is going to college important to your future?

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* 28. Is going to college important to your future?

Do your family members encourage you to go to college?

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* 29. Do your family members encourage you to go to college?

If you are 18 years or older, have you ever voted in an election?

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* 30. If you are 18 years or older, have you ever voted in an election?

I have been or am I currently in..

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* 31. I have been or am I currently in..

About how often do you volunteer to help people in need?

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* 32. About how often do you volunteer to help people in need?

Complete the statements below in the way that is most like you

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* 33. Complete the statements below in the way that is most like you

  My Family My Friends My School My Neighborhood San Antonio
When I think about helping my community, I think about helping...
When I think about those in need in my community, I think about...
When I think about important social issues, I worry about...
I think my TEAM UP project will help....
How do you get your news?

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* 34. How do you get your news?

Please tell us how much you agree or disagree with the following statements

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* 35. Please tell us how much you agree or disagree with the following statements

  Yes, I agree No, I disagree I don't know
I know a lot of people in my neighborhood
I know what I can do to make my school a better place
I can't make a difference in San Antonio
I think the more people help other, the better the world will be 
Helping others is important to me
Everyone should pay attention to the news, including myself 
How well do the following statements describe you?

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* 36. How well do the following statements describe you?

  Exactly like me A little like me Not like me at all 
I only help people if it is easy or I get something in return
I feel I must help people in my neighborhood
When I meet people who are having a hard time, I wonder how I would feel in their shoes
I try to think of ways to help people
I pay attention to the news that affects San Antonio
Who came up with the idea for your project?

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* 37. Who came up with the idea for your project?

How often did your college scholar help with the project?

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* 38. How often did your college scholar help with the project?

Who will become involved with your project over the school year?

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* 39. Who will become involved with your project over the school year?

Please tell us how much you agree or disagree with the following statements

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* 40. Please tell us how much you agree or disagree with the following statements

  Agree Neither Agree or Disagree Disagree
Overall, I feel good about being in my project group
I can see my ideas used in the final project
I was an important part of my group
I learned something during my project that I can use outside of school
Please tell us how often the following statements happen

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* 41. Please tell us how often the following statements happen

  Always Sometimes Rarely
My group listens to what I had to say
When my group has a problem, we work together to solve the problem
Can you see how your project makes a difference to the community?

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* 42. Can you see how your project makes a difference to the community?

While doing my project, I am learning...

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* 43. While doing my project, I am learning...

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