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1. How old are you? (Required.)

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2. What grade are you in?

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3. What school do you attend? (Required.)

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4. Are you currently enrolled in a Jewish religious school?

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5. Are you currently enrolled in a Jewish day school?

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6. What congregation are you affiliated with? (Required.)

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7. What was/or is the highest grade of Jewish school that you attended?

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8. How would you describe your Jewish identity? (Required.)

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9. How often have you participated in Jewish youth programs in the past 12 months? (Required.)

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10. Have you participated in any informal Jewish programs in the past 12 months? Check all that apply. (Required.)

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11. Have you attended an overnight Jewish camp in the past 12 months? (Required.)

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12. How often have you participated in Jewish youth programs in the past 12 months? (Required.)

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13. Have your ever traveled to Israel? Check all that apply.

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14. How many hours per week do you spend on the following activities? (Required.)

  0 hrs/wk 1-3 hrs/wk 4-5 hrs/wk 6-7 hrs/wk 8-9 hrs/wk 10+ hrs/wk
Sports
Homework
Jewish activities
Inter-active games
Job (employment)
Volunteer
Mitzvah project
Madrichim (religious school assistant)

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15. How important is it to you to have Jewish friends? (Required.)

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16. Why do you participate in Jewish activities? Select up to 3 choices. (Required.)

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17. What prevents or discourages you from participating in more Jewish activities? Select up to 3 choices. (Required.)

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18. What do you like most about being Jewish? (Required.)

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19. Please list your top 3 either existing programs/ events or newly created programs/events that you would like to see for teens in the Detroit area. (Required.)

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20. What is your e mail address? (Required.)

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