Classic Summer Survey

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First Name *

Last Name *

What is your email address? *

If you do not have one, please enter NA

What is your cell phone number? *

Please write in this format - 304-123-1234. If you do not have one, please enter NA.

What is the best contact number for your parents during the summer? Write parent NAME and PHONE NUMBER in this format - 304-123-1234. Can this number receive texts? *

Please rank order your choices for Sunday/Thursday Wellness Activities - Select your top three choices and mark DO NOT WANT for the rest *

First Choice

Second Choice

Third Choice

DO NOT WANT

Basketball

Swimming/Fitness Walking

Frisbee/Kickball

Yoga

Body Pump

Strength Training

Body Pump

Please rank order your choices for Monday Cultural Activities - Select your top three choices and mark DO NOT WANT for the rest *

First Choice

Second Choice

Third Choice

DO NOT WANT

Dance

Improv/Theatre

Print Making

West African Drumming

Zentangle

Painting

Zentangle / Cultural Dancing / Printmaking / West African Drumming

What size t-shirt do you want for your UB summer shirt? *

This is a unisex standard size shirt

Small

Medium

Large

X-Large

XX-Large

XXX-Large

Please list your first choice of a roommate for Summer *

If you do not have a preference - please say "I don't care"

Please list your second choice of a roommate for Summer *

If you do not have a preference - please say "I don't care"

Please choose your top choice for shadowing during career day? *

If you are a junior, you may want to choose a different career than last summer. We will all be exploring Engineering as a group career.

Please choose your SECOND choice for shadowing during career day? *

We will attempt to put you in your first choice, however in the event it is filled, we will place you in your backup career choice to shadow for the day.

Would you be interested in participating in an optional book club this summer (reading The House on Mango Street)? We will give books to those who are interested! *

Yes

Do you plan to attend the Classic Summer Program? *

Yes! I am excited about it

Yes, but I am hesitant/nervous

No, I do not plan to attend but I would like to continue to participate in UB during the academic year.

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