ConnectiKids Program Evaluation Survey - Spring 2018
Name
Your answer
Gender
Grade *
School *
Tutoring Site *
How many years have you been in the ConnectiKids Program?
Your answer
Mark ALL of the things you talk about with any adult at ConnectiKids.
Mark ALL of the things your tutor does for you.
Mark ALL of the adults you feel comfortable with when you are at ConnectiKids.
Do you like yourself?
Are you proud of yourself?
Mark ALL of the words that describe you.
Mark ALL of the goals you have for continuing your education.
I will study hard for good grades.
I understand the importance of attending school.
I will work hard to reach my goals.
I want to be a positive member of my community.
I will have a good job when I grow up.
I meet new people at ConnectiKids.
I go new places with ConnectiKids.
I learn new things at ConnectiKids.
Fill in the blank: Going to ConnectiKids makes me feel
Your answer
Have you met any positive role models at ConnectiKids?
If yes, write their names
Your answer
Name THREE skills or talents you are good at.
Your answer
What skill or talent would you like to get better at?
Your answer
Mark ALL of the things you do when faced with challenges.
Mark ALL of the people you feel comfortable going to when faced with a peer conflict or issue.
Mark ALL of the things you feel confident to do when faced with peer pressure.
Thank you!!
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