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* 1. Name

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* 2. Grade

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* 3. Age

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* 4. Gender

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* 5. Type of Academic Institution Currently Attending (check all that apply):

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* 6. Extracurricular Activities & Number of Years (e.g Basketball - 4 years):

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* 7. Has anyone ever encouraged you to to participate in a STEM related activity, course, or curriculum?

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* 8. If yes, who? (Check all that apply)

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* 9. Has anyone ever discouraged you to to participate in a STEM related activity, course, or curriculum?

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* 10. If yes, who? (Check all that apply)

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* 11. What career field would you like to work in as an adult?

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* 12. If you had to choose a S.T.E.M field to work in as an adult, it would be (check all that apply):

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* 13. What Math Course(s) did you take in the 2019 - 2020 school year?

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* 14. Number of S.T.E.M Courses Taken:

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* 15. Years of Video Game Playing Experience:

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* 16. Are you currently enrolled in honors or advanced courses?

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* 17. Do you plan on enrolling in honors or advanced courses next year?

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* 18. Are you enrolled in a special engineering, mathematics, or science curriculum?

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* 19. Are you or have you ever been enrolled in a computer science (or related) course?

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* 20. Number of Computer Science (or Related) Courses Taken:

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* 21. What do you plan to do when you graduate from high school?

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* 22. What is the chance that you will go to college?

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* 23. If you decide to go to a college or university, what is the chance that you will study engineering or something related to technology?

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* 24. If you decide to go to college, do you think you will pursue a career in something to do with science, engineering, or mathematics?

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* 25. If you decide to go to a college or university, what is the chance that you will study computer science (including game design)?

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* 26. In the future, do you think you want to be a scientist, engineer, or mathematician?

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* 27. In the future, do you think you want to be a computer scientist?

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* 28. Do you know anyone who is a scientist, engineer, mathematician, computer scientist or professional gamer?

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* 29. If yes, who? (Check all that apply)

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* 30. If yes to Question 28, (Part 2) has this individual ever encouraged you to participate in a stem-related activity, course, or curriculum?

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* 31. If yes to Question 28,how do you know this individual that is a scientist, engineer, mathematician, computer scientist or professional gamer?

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* 32. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that makes me think]

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* 33. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that allows me to make lots of money]

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* 34. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that allows me to use math, computer, engineering, science, or gaming skills]

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* 35. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that allows me to tell other people what to do]

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* 36. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that allows me to help solve problems and create solutions]

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* 37. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that is fun to do]

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* 38. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that allows me to have time with family]

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* 39. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that allows me to help my community and/or society]

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* 40. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that makes people think highly of me]

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* 41. The following statements describe work or jobs you might do in the future. Tell us how important each of the items below is to you in your future work. How important is it to you to do . . . [Work that is satisfying to me]

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* 42. Why did you decide sign up for the Pro Gamer Clinic?

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