Solvay 21st CCLC - Grades 5-12 Student Survey

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* 1. Date

Fall 2019

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* 2. Program Site

Middle School

High School

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* 3. Grade

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* 4. How often do you come to the Extended School Day after-school program?

Every day/Almost every day program is offered

Twice a week

Once a week

Twice a month

Once a month or less

Just started attending

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* 5. Please respond to the following questions and be honest - there is no right or wrong answers.

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* 6. Please indicate your level of interest in participating in activities related to each of the following areas.

	Very interested	Interested	Not very interested	Not at all interested
Homework Help/Improving Grades	Homework Help/Improving Grades Very interested	Homework Help/Improving Grades Interested	Homework Help/Improving Grades Not very interested	Homework Help/Improving Grades Not at all interested
Career Exploration	Career Exploration Very interested	Career Exploration Interested	Career Exploration Not very interested	Career Exploration Not at all interested
Community Service Projects	Community Service Projects Very interested	Community Service Projects Interested	Community Service Projects Not very interested	Community Service Projects Not at all interested
Science	Science Very interested	Science Interested	Science Not very interested	Science Not at all interested
Technology	Technology Very interested	Technology Interested	Technology Not very interested	Technology Not at all interested
Engineering	Engineering Very interested	Engineering Interested	Engineering Not very interested	Engineering Not at all interested
Mathematics	Mathematics Very interested	Mathematics Interested	Mathematics Not very interested	Mathematics Not at all interested
Reading/Literacy	Reading/Literacy Very interested	Reading/Literacy Interested	Reading/Literacy Not very interested	Reading/Literacy Not at all interested
Arts	Arts Very interested	Arts Interested	Arts Not very interested	Arts Not at all interested
Music/Chorus	Music/Chorus Very interested	Music/Chorus Interested	Music/Chorus Not very interested	Music/Chorus Not at all interested
Theater/Drama	Theater/Drama Very interested	Theater/Drama Interested	Theater/Drama Not very interested	Theater/Drama Not at all interested
Health and Nutrition	Health and Nutrition Very interested	Health and Nutrition Interested	Health and Nutrition Not very interested	Health and Nutrition Not at all interested
Sports, Fitness, and Recreation	Sports, Fitness, and Recreation Very interested	Sports, Fitness, and Recreation Interested	Sports, Fitness, and Recreation Not very interested	Sports, Fitness, and Recreation Not at all interested
Life Skills/Personal Development	Life Skills/Personal Development Very interested	Life Skills/Personal Development Interested	Life Skills/Personal Development Not very interested	Life Skills/Personal Development Not at all interested
Financial Literacy	Financial Literacy Very interested	Financial Literacy Interested	Financial Literacy Not very interested	Financial Literacy Not at all interested

	Yes	Usually	Not really	No
Do you like to learn new things?	Do you like to learn new things? Yes	Do you like to learn new things? Usually	Do you like to learn new things? Not really	Do you like to learn new things? No
Do you "give up" easily?	Do you "give up" easily? Yes	Do you "give up" easily? Usually	Do you "give up" easily? Not really	Do you "give up" easily? No
Do you try to learn from your mistakes?	Do you try to learn from your mistakes? Yes	Do you try to learn from your mistakes? Usually	Do you try to learn from your mistakes? Not really	Do you try to learn from your mistakes? No
Before making a decision, do you stop and think about your choices?	Before making a decision, do you stop and think about your choices? Yes	Before making a decision, do you stop and think about your choices? Usually	Before making a decision, do you stop and think about your choices? Not really	Before making a decision, do you stop and think about your choices? No
Do you think about how your choices affect others?	Do you think about how your choices affect others? Yes	Do you think about how your choices affect others? Usually	Do you think about how your choices affect others? Not really	Do you think about how your choices affect others? No
Do you set goals for yourself?	Do you set goals for yourself? Yes	Do you set goals for yourself? Usually	Do you set goals for yourself? Not really	Do you set goals for yourself? No
Are you willing to work hard on something difficult?	Are you willing to work hard on something difficult? Yes	Are you willing to work hard on something difficult? Usually	Are you willing to work hard on something difficult? Not really	Are you willing to work hard on something difficult? No
Do you treat others the way you want to be treated?	Do you treat others the way you want to be treated? Yes	Do you treat others the way you want to be treated? Usually	Do you treat others the way you want to be treated? Not really	Do you treat others the way you want to be treated? No
Are you comfortable being a leader?	Are you comfortable being a leader? Yes	Are you comfortable being a leader? Usually	Are you comfortable being a leader? Not really	Are you comfortable being a leader? No
Do you show respect for others' ideas?	Do you show respect for others' ideas? Yes	Do you show respect for others' ideas? Usually	Do you show respect for others' ideas? Not really	Do you show respect for others' ideas? No
Do you get along with others who are different from you?	Do you get along with others who are different from you? Yes	Do you get along with others who are different from you? Usually	Do you get along with others who are different from you? Not really	Do you get along with others who are different from you? No
Are you comfortable voicing your opinion?	Are you comfortable voicing your opinion? Yes	Are you comfortable voicing your opinion? Usually	Are you comfortable voicing your opinion? Not really	Are you comfortable voicing your opinion? No
Do you bounce back from setbacks and disappointments easily?	Do you bounce back from setbacks and disappointments easily? Yes	Do you bounce back from setbacks and disappointments easily? Usually	Do you bounce back from setbacks and disappointments easily? Not really	Do you bounce back from setbacks and disappointments easily? No
Do you like going to school?	Do you like going to school? Yes	Do you like going to school? Usually	Do you like going to school? Not really	Do you like going to school? No
Are you a good student?	Are you a good student? Yes	Are you a good student? Usually	Are you a good student? Not really	Are you a good student? No
Is getting good grades important to you?	Is getting good grades important to you? Yes	Is getting good grades important to you? Usually	Is getting good grades important to you? Not really	Is getting good grades important to you? No
Do you actively participate in class discussions?	Do you actively participate in class discussions? Yes	Do you actively participate in class discussions? Usually	Do you actively participate in class discussions? Not really	Do you actively participate in class discussions? No
Is your homework completed on time?	Is your homework completed on time? Yes	Is your homework completed on time? Usually	Is your homework completed on time? Not really	Is your homework completed on time? No
Do you understand what you are learning in your classes?	Do you understand what you are learning in your classes? Yes	Do you understand what you are learning in your classes? Usually	Do you understand what you are learning in your classes? Not really	Do you understand what you are learning in your classes? No
Are you comfortable asking a teacher for help when you do not understand your school work?	Are you comfortable asking a teacher for help when you do not understand your school work? Yes	Are you comfortable asking a teacher for help when you do not understand your school work? Usually	Are you comfortable asking a teacher for help when you do not understand your school work? Not really	Are you comfortable asking a teacher for help when you do not understand your school work? No
Do you feel a sense of belonging at your school?	Do you feel a sense of belonging at your school? Yes	Do you feel a sense of belonging at your school? Usually	Do you feel a sense of belonging at your school? Not really	Do you feel a sense of belonging at your school? No
Are you confident in yourself and your abilities?	Are you confident in yourself and your abilities? Yes	Are you confident in yourself and your abilities? Usually	Are you confident in yourself and your abilities? Not really	Are you confident in yourself and your abilities? No
Do you believe you need to do well in school to reach your future goals?	Do you believe you need to do well in school to reach your future goals? Yes	Do you believe you need to do well in school to reach your future goals? Usually	Do you believe you need to do well in school to reach your future goals? Not really	Do you believe you need to do well in school to reach your future goals? No
Do you think it is important to go to college?	Do you think it is important to go to college? Yes	Do you think it is important to go to college? Usually	Do you think it is important to go to college? Not really	Do you think it is important to go to college? No
Do you understand the connection between what you are learning in school and how it will be useful in college and/or future career?	Do you understand the connection between what you are learning in school and how it will be useful in college and/or future career? Yes	Do you understand the connection between what you are learning in school and how it will be useful in college and/or future career? Usually	Do you understand the connection between what you are learning in school and how it will be useful in college and/or future career? Not really	Do you understand the connection between what you are learning in school and how it will be useful in college and/or future career? No

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* 1. Date

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* 2. Program Site

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* 3. Grade

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* 4. How often do you come to the Extended School Day after-school program?

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* 5. Please respond to the following questions and be honest - there is no right or wrong answers.

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* 6. Please indicate your level of interest in participating in activities related to each of the following areas.

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* 7. Please list three (3) positive behaviors.