National Youth Outcomes Initiative Survey (Club Experience Only: Teen 13+)
Instructions:

Thank you very much for taking this survey today! Your opinion is important to us and we appreciate your time.
This survey is designed to find out about you, your opinions and your experiences. Your answers will help make the Boys & Girls Clubs and Military Youth/Teen Centers more interesting and enjoyable for you and others like you. So please answer honestly.

You can answer honestly because your survey won't have your name on it, and nobody seeing the survey will know your name. This means your answers will never be shared with your parents, friends, or anyone in your Club. Your answers will be kept confidential and used to better understand Boys & Girls Clubs, Military Youth/Teen Centers and their members.

Instructions:
1. This is not a test. There are no right or wrong answers.
2. If you don’t find the answer that fits exactly, use the answer that comes closest.
3. If you need help with a question, raise your hand and quietly ask the staff member helping you today
so that you don’t disturb others around you.
4. If any question makes you feel uncomfortable, you don’t have to answer it. Just skip it and go to the next question.

Remember, there are no right or wrong answers – only your opinion and your experiences. Thanks again!
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What is your Club member ID Number? *
What Clubhouse do you go to? *
What is your birthdate? *
Please mark the appropriate answer.
MM
/
DD
/
YYYY
What grade are you in? *
Please mark the appropriate answer.
Are you a... *
Please mark the appropriate answer.
What is your race/ethnicity? *
Please choose all that apply to you.
Required
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