2019 UMS 21CCLC Student Survey
Answer each question based on your experiences in SPLASH.
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Your Gender *
Your Grade Level *
How many years have you particiapted in SPLASH? *
How many SPLASH sessions have you attended this school year? *
Number of Days You Attended SPLASH (During an average week) *
Activities You Participated in This Year (Check all that apply) *
Required
In general, compared to one year ago, how would you describe your grades in school? *
Please read each of the following statements about SPLASH and select the answer that best describes your feelings about the program. *
Never
Sometimes
Most of the Time
Always
There is an adult in the program who I can talk to about problems or issues.
Staff members at the program ask me how I am doing.
If I do not come to the program, there is at least one staff member who will notice I am not there.
There is a staff member at the program who has helped me set higher goals for myself.
The program staff enjoy hearing what I am thinking about.
It is easy for me to talk to the program staff.
If I don't come to the program, I would eat supper at home.
I have a positive relationship with at least one teacher in the program.
How much do you agree or disagree with each of the following statements about SPLASH? *
Strongly Disagree
Disagree
Agree
Strongly Agree
I learn about things I'm not taught in school.
The activities challenge me to do my best.
The activities are fun.
The staff make me laugh.
Sometimes we do silly things, just for the fun of it.
Staff make learning fun.
I enjoy coming to the program.
I have made friends in the program.
I feel safe at the program.
How much do you agree or disagree with each of the following statements: Since attending SPLASH I ...
Agree
Neutral
Disagree
Better understand my homework.
Complete my homework more often.
Attend school more often.
Come to school better prepared.
Participate more in class.
Get better grades.
Enjoy school more.
Am a better reader.
Have an overall improved attitude about school.
Have received fewer referrals.
Clear selection
Overall, how happy are you with SPLASH? *
What NEW SPLASH classes would you like to be offered next year?
Please list foods that you would like to see served for dinner at SPLASH.
Why do you attend SPLASH?
Is there anything else you would like to tell us about the SPLASH program?
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