* 1. Project Name and Date

* 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.

* 3. What is your gender?

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

* 5. What grade are you in?

* 6. What is your School?

* 7. How would you describe yourself?

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

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

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

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

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

* 13. Has your Mother graduated from college?

* 14. Has your Father graduated from college?

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

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

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

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

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

* 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?

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

* 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 

* 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 

* 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

* 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 

* 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

* 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

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

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

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

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

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

* 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....

* 34. How do you get your news?

* 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 

* 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

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

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

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

* 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

* 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

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

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

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