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* 1. School Name:

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* 2. Adult Champion(s) name(s):

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* 3. Position of Champion(s) in School: (ie. Teacher, Parent, etc.)

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* 4. How long have you been an Ever Active School? (Associate or Member)

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* 5. Of the four priority areas – physical activity, healthy eating, student leadership and positive social environments – which of these has been the focus during the 2012/13 school year?

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* 6. Please describe your program(s)/initiative(s)

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* 7. How long has the program(s) been running? (Months or years)

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* 8. How do the following people contribute to the program described above? (ie. leadership roles, committee members, sponsors or partners)

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* 9. How do you monitor or assess the progress and success of your program(s)? (ie surveys, pedometers, student and staff input etc.)

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* 10. What challenges and barriers did you find most difficult to overcome or still struggle with today?

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* 11. Do you have any advice for other schools wishing to create healthy active school communities?

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* 12. What are your future plans in terms of sustaining and continuing your program(s)/initiative(s) within your school?

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* 13. What is the best thing about your healthy active school community that you’d like people to know?

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* 14. Can we provide your name and email address at the end of the article?

Thank you for sharing your success story with Ever Active Schools!

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