After-School Program survey Template

1. What is your age?

The answer should be a single choice:

1. Under 18
2. 18-24
3. 25-34
4. 35-44
5. 45-54
6. 55-64
7. 65 or older

2. What is your gender?

The answer should be a single choice:

1. Male
2. Female
3. Other
4. Prefer not to say

3. Do you currently participate in any after-school activities?

The answer should be a single choice:

1. Yes
2. No

4. If yes, please select all that apply:

The answer should be a single choice:

1. Sports
2. Music lessons
3. Art classes
4. Tutoring
5. Mentoring

5. If no, what is the primary reason you do not participate in after-school activities?

The answer should be a single choice:

1. None available in my area
2. Cost
3. Scheduling conflicts
4. Lack of interest

6. Which of the following after-school activities would you be interested in participating in? (Select all that apply)

The answer should be a multiple choice:

1. Sports
2. Music lessons
3. Art classes
4. Tutoring
5. Mentoring

7. What time would be most convenient for you to participate in after-school activities?

The answer should be a single choice:

1. Immediately after school
2. Late afternoon (4-6 pm)
3. Early evening (6-8 pm)

8. What type of after-school program are you most interested in?

The answer should be a single choice:

1. Academic enrichment
2. Sports and recreation
3. Arts and culture
4. Mentoring and personal development

9. What specific activities would you like to see offered in an after-school program? (Please list up to three)

The answer should be a multi line text input.

10. On a scale of 1-5, how important do you think after-school programs are for children and youth?

The answer should be a single choice:

1. 1 - Not at all important
2. 2 - Slightly important
3. 3 - Moderately important
4. 4 - Very important
5. 5 - Extremely important

11. What improvements or changes would you suggest for after-school programs in your area?

The answer should be a multi line text input.