CSI Middle School Survey
We want to hear from you so we can keep improving our programs and content to better serve today's youth. Please complete this survey and let us know your true thoughts. 

(This survey is designed to collect information for improvement of a nonprofit youth mentoring program only.) 

For completing the survey you will be placed in a prize drawing.

Sign in to Google to save your progress. Learn more
Email *
Student Name
Grade
Clear selection
School Name
Are you a part of any afterschool or extracurricular activities at your school? *
What type of afterschool activities would you like for your school to have? *
What extracurricular activities are you a part of outside of school? *
What day of the week would you prefer to participate in activities in school or outside of school? *
Would you participate in a program that allows you to be yourself, express yourself and be heard? *
Rate your type of incentives that you would like to receive for your participation. *
Dislike
Cool
Like
Prefer to have
Gift Card
Promotional Item (T-shirt, Backpack, etc.)
Certificate
Technology (chargers, earbuds, power banks, etc.)
Do you feel the need to have a youth mentoring program in your community? *
Would you be interested in having a mentor? *
Have you ever been bullied? *
Have you ever bullied someone? *
Do you find yourself being able to be your authentic (real) self around your friends? *
If you are not able to be your authentic (real) self around your friends, what is keeping you from it?
Should you find yourself in trouble at school and given the option to pick between in school suspension or attend a mentoring program, which one would you choose? *
Would you like to receive information about Collective Souls, Incorporated, a nonprofit community organization that is designed to educate, mentor, and nurture today's middle and high school youth in the community.
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms