Youth Civic Health Survey
The YMCA Youth Civic Health Survey is inspired by the National Conference on Citizenship's (NCoC)
Civic Health Index
, which utilizes indicators of civic health collected by the U.S. Census Bureau and Bureau of Labor Statistics as part of the Civic Engagement and Volunteerism Supplement of the
Current Population Survey (CPS)
.
Survey Agreement
By completing this survey, you consent to sharing your responses with the YMCA of the USA (The Y). No personal or contact information will be collected beyond demographic data, and all survey responses are anonymous.
Survey Agreement
I agree to participate
School Year
Please select...
2024-2025
Demographic Questions
Age
Please select...
11
12
13
14
15
16
17
18
19
20
Grade
Please select...
6
7
8
9
10
11
12
Gender
Please select...
Male
Female
Gender Non-Conforming
Gender Not Listed
Home Zip Code
Community Type
Please select...
Rural
Urban
Suburban
Race/Ethnicity
American Indian or Alaska Native
Asian
Black or African-American
Hispanic or Latino/a
Native Hawaiian or Other Pacific Islander
White/Caucasian
You may choose one or more, however many apply to you.
Which of the following Asian groups are you?
Please select...
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Which of the following Native Hawaiian or Other Pacific Islander groups are
you?
Please select...
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
Which group do you most closely identify
with?
Please select...
Mexican
Mexican American
Chicano
Puerto Rican
Cuban
Cuban-American
Other Spanish, Hispanic, or Latino group
Participant Type
If your school is not listed after selecting your state, your school's teacher/advisor has not yet completed the YMCA Civic Health Champion
Certification Form
. Please email
jamie@ymcayag.org
with any questions.
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alabama School
Please select...
Choice A
Choice B
Choice C
Alaska School
Please select...
Choice A
Choice B
Choice C
Arizona School
Please select...
Brophy High School
Chaparral High School
Desert Meadows
Glenn L. Downs Social Sciences Academy
Mountain View High School
Paradise Honors High School
Prescott High School
Ridgeline Academy
Shadow Mountain High School
Arkansas School
Please select...
Choice A
Choice B
Choice C
California School
Please select...
Choice A
Choice B
Choice C
Colorado School
Please select...
George Muller Academy
Prairie Creek High School
Connecticut School
Please select...
Cloonan Middle School
Newtown Middle School
Pulaski Middle School
Schaghticoke Middle School
The House of Arts, Letter and Science (HALS Academy)
Timothy Edwards Middle School EXCEL Program
Delaware School
Please select...
Choice A
Choice B
Choice C
District of Columbia School
Please select...
Cardozo Education Campus
Friendship Collegiate Academy
Jackson-Reed High School
School Without Walls
Florida School
Please select...
Allen D. Nease High School
Atlantic Coast High School
Cape Coral High School
Dunedin Middle School
Fort Myers High School
George Jenkins High School
Lake Mary High School
Lecanto High School
Martin County High School
North Fort Myers High School
Oak Hall High School
Paul Laurence Dunbar Middle School
South Fork High School
Georgia School
Please select...
Choice A
Choice B
Choice C
Hawaii School
Please select...
Choice A
Choice B
Choice C
Idaho School
Please select...
Choice A
Choice B
Choice C
Illinois School
Please select...
Addison Trail High School
Andrew High School
Batavia High School
Benton
Bradley Bourbonnais Community High School
Carl Sandburg High School
Carmel Catholic High School
Carterville High School
Chicago Academy of the Arts
East Leyen High School
Eisenhower High School
Eldorado High School
Frankfort Community High School
Glenbrook North High School
Homewood Flossmoor
Instituto Health Sciences
Intrinstic Schools
Kenwood Academy
Lake Park High School
Metea Valley High School
Mt. Vernon Township High School
Naperville Central High School
Naperville North High School
Neuqua Valley High School
Oswego High School
Pinckneyville High School
Richards High School
Sesser-Valier High School
Shephard
St. Charles Compass Academy
St. Edward Central Catholic High School
Stagg High School
Sycamore High School
Waltonville High School
Waubonsie Valley High School
West Leyen High School
Westmont High School
Wheaton North
Wheaton Warrenville South High School
Whitney Young
Williamsville High School
Woodlawn High School
Indiana School
Please select...
Bosse High School
Butler Lab School 60
Butler University Lab School 60
Carroll High School
Castle High School
Charles Tindley High School
Columbia City High School
Concordia High School
DeKalb High School
Eastbrook
Easy Allen University
Evansville Central High School
Evansville North High School
Evansville North Jr. High School
Fegley Middle School
Fremont
Greater Jasper School
Greensburg Community High School
Hamilton
Harrison High School (Evansville)
Herron High School
Highland Hills Middle School
Homeschool
Homestead High School
John R. Wooden Middle School
Le Porte High School
Le Porte Middle School
Logansport High School
Lynhurst 7th and 8th Grade Center
Madison-Grant
Marion
McGary Middle School
Memorial Park Middle School
Mississinewa
MSD
New Albany High School
New Tech High School
North Central
North High School
North Spencer School
Northeast Dubois
Northrop High School
Northview Middle School
Northwood Middle School
Oak Hill
Perry Central Community Schools
Plaza Park International Prep Academy
Portage High School
Prairie Heights
Purdue Polytechnic High School
Reitz High School
Scribner High School
Shawnee Middle School
Sheridan High School
Signature School High School
Simon Youth Academy
Snider High School
South Spencer School
Southeast Dubois School
Southside High School
Southwest Dubois School
Summit Middle School
Tell City Troy Township
Wabash City Schools, MSD of Wabash County
Washington Middle School (Evansville)
Wayne High School
Whitley County Consolidated
Willowcreek Middle School
Woodside Middle School
Iowa School
Please select...
Choice A
Choice B
Choice C
Kansas School
Please select...
Choice A
Choice B
Choice C
Kentucky School
Please select...
Bullitt Central High School
Eastern High School
Foundation Christian Academy
Lafayette High School
Montgomery County High School
Pendleton County High School
Phillip A. Sharp Middle School
Pikeville High School
Russell County High School
South Oldham High School
Talton K. Stone Middle School
Walton-Verona HS
West Carter County High School
Williamstown Sr High School
Winburn Middle School
Louisiana School
Please select...
Choice A
Choice B
Choice C
Maine School
Please select...
Gorham High School
Kingswood Regional High School
Maine Central Institute
Maryland School
Please select...
ACCE
Bethesda Chevy Chase High School
Catholic High School
City Neighbors High School
Clarksburg High School
Columbia Heights Education Campus (CHEC)
Dulaney High School
Forest Park High School
Homeschool
La Plata High School
Liberty High School
Mervo High School
Montgomery Blair
New Hope Academy
Patterson High
Perry Hall High School
Reginald F. Lewis High School
Urbana High
Urbana High School
Virtual/Home School
Walter Johnson
Massachusetts School
Please select...
Helen Y Davis Leadership Academy
Keith Middle School
Richardson Middle School
Michigan School
Please select...
Airport High School
Athens High School
Beal City Schools
Bronson Jr/Sr High School
Bronson Middle School
CA Frost Middle/High School
Cadillac High School
Caro High School
Cass Technical High School
Chandler Park Academy High School
Cheboygan High School
Clague Middle School
Clarenceville High School
Cody High School
Coldwater High School
Crockett Midtown High School of Science and Medicine
Detroit Lions Academy
Dexter High School
Eaton Rapids High School
Elk Rapids High School
Everett High School
Forest Hills Eastern High School
Fruitport High School
Gladstone Area Schools
Harbor Springs High School
Harbor Springs Middle School
Hastings High School
Holland High School
Interlochen Arts Academy
L'Anse Area Schools
Lakeshore Middle School
Legg Middle School
Loy Norrix High School
Manistee Middle/High School
Marist Academy
Marshall High School
Mason Consolidated High School (Erie)
Mason High School
Mill Creek Middle School
Mio AuSable High School
Mio AuSable School
Munising Middle/High School
Notre Dame Preparatory School
Novi High School
Onsted High School
Petoskey High School
Petoskey Middle School
Portage Northern High School
Reading High School
Renaissance High School
River Rouge High School
Rochester Adams High School
Saginaw Heritage High School
Samuel C. Mumford High School
Sturgis High School
Sturgis Middle School
Superior Central High School
Superior Central Middle School
Union City High School
Union High School
Vassar Middle & High School
Vassar Middle School
Wayland Union High School
West Side Academy
Western High School
White Pigeon Jr/Sr High School
Minnesota School
Please select...
Bloomington Jefferson High School
Champlin Park High School
Hopkins Public Schools
Olson Middle School
Open World Learning
Park Center High School
Prior Lake High School
Rochester Century High School
Saint Paul Conservatory for Performing Arts
South High School
St. Louis Park High School
Woodbury High School
Mississippi School
Please select...
Choice A
Choice B
Choice C
Missouri School
Please select...
Cardinal Ritter College Prep
Carr Lane Middle School
Confluence Preparatory Academy
Lindbergh High School
Rockwood Summit High School
Sumner High School
Montana School
Please select...
Choice A
Choice B
Choice C
Nebraska School
Please select...
Choice A
Choice B
Choice C
Nevada School
Please select...
Choice A
Choice B
Choice C
New Hampshire School
Please select...
Berlin Middle High School
Exeter High School
Stevens High School
New Jersey School
Please select...
Choice A
Choice B
Choice C
New Mexico School
Please select...
Albuquerque Academy
Albuquerque High School
Albuquerque Institute for Math & Science
Cibola High School
Cottonwood Classical Preparatory School
East Mountain High School
Edgewood Middle School
Los Alamos High School
Moriarty High School
Moriarty Middle School
Santa Fe High School
Southwest Secondary Learning Center
Tierra Encantada Charter School
West Mesa High School
New York School
Please select...
Choice A
Choice B
Choice C
North Carolina School
Please select...
Calvary Day School
Davie County High School
Early College of Forsyth
Parkland High School
Reynolds High School
Salem Academy
North Dakota School
Please select...
Choice A
Choice B
Choice C
Ohio School
Please select...
Archbishop Carroll High School
Collinwood High School
Highland High School- Marengo
Lexington High School
Mansfield Senior High School
New Tech West
Oklahoma School
Please select...
Perry High School
Putnam City North High School
Oregon School
Please select...
Crescent Valley High School
Dayton High School
Grants Pass High School
Hidden Valley High School
Illinois Valley High School
New Hope Christian School
North Eugene
North Valley High School
Rogue River Jr/Sr High School
Sherwood High School
South Eugene
Tillamook High School
West Albany High School
West Salem High School
Pennsylvania School
Please select...
Choice A
Choice B
Choice C
Rhode Island School
Please select...
Nathanael Greene Middle School
Wilbur-MacMahon School
South Carolina School
Please select...
Beaufort High School
Bluffton High School
Brashier Middle College Charter School
Cardinal Newman Catholic School
Easley High School
Fountain Inn High School
GREEN Charter School
Greenville High School
Heathwood Hall
Hughes Academy
Mauldin High School
Palmetto High School
St. Joseph’s Catholic School
South Dakota School
Please select...
Choice A
Choice B
Choice C
Tennessee School
Please select...
South Warren High School
Texas School
Please select...
Alief Early College High School
Fox Tech High School
Grand Prairie High School
Utah School
Please select...
Choice A
Choice B
Choice C
Vermont School
Please select...
Albany Community School
Albert D. Lawton School
Alburg Community Education Center
Arlington Memorial
Bakersfield School
Barnet Elmentary School
Barre City Elementary/Middle School
Barre Town Elementary & Middle School
Barstow Memorial School
Barton Graded School
Bellcate School
Bellows Falls Middle School
Bellows Falls Union High School
Bellows Free Academy (St. Albans)
Bellows Free Academy Middle/High School (Fairfax)
Benson Village School
Berkshire Elementary School
Blue Mountain Union School
Brattleboro Area Middle School
Brattleboro Union High School
Brewster Pierce School
Brighton Elementary
Brookfield School
Brown River Middle School
Brownington Central School
Burke Mountain Academy
Burke Town School
Burlington High School
Burlingtoon Tech Center
Burr and Burton Academy
C. P. Smith School
Cabot School
Camels Hump Middle School
Canaan Schools
Castleton Village School
Center for Technology
Centerpoint
Central Vermont Career Center
Champlain Valley Union High School
Charleston Elementary
Charlotte Central School
Colchester High School
Colchester Middle School
Cold Hollow Career Center
Concord Graded/Middle School
Coventry Village School
Craftsbury Schools
Crossett Brook Middle School
Danville School
Dorset Elementary School
Dummerston Schools
East Burke School
East Meadow School
East Valley Academy
Edmunds Middle School
Enosburg Falls Middle/High School
Essex High School
Essex Middle School
Fair Haven Union Middle and High School
Fairfield Center School
Fay Honey Knopp Memorial School
First Branch Middle School
Fisher School
Flood Brook School
Folsum Education & Community Center
Foundations
Franklin Central School
Frederick H. Tuttle Middle School
Georgia Elementary & Middle School
Glover Community School
Grace Christian School
Green Mountain Tech & Career Center
Green Mountain Union High School
Green Mountain Valley School
Greenwood School
Halifax School
Hartford Career & Tech Center
Hartford High School
Hartford Memorial Middle School
Hartland Elementary
Harwood Union Middle/High School
Hazen Union High School
Hinesburg Community School
Inspire
Irasburg Village School
Jamaica Village School
Killington Mountain School
Kindle Farm
Lake Champlain Waldorf School
Lake Region Union High School
Lakeview Union School
Lamoille Union High School
Lamoille Union Middle School
Laraway School
Leland & Gray Union Middle & High School
Long Trail School
Lothrop School
Lowell Graded School
Lyman C. Hunt Middle School
Lyndon Institute
Lyndon Town School
Main Street Middle School
Manchester Elementary/Middle School
Maplehill School
Marlboro Elementary School
Mater Christi School
Mid Vermont Christian Scchool
Middlebury Union Middle School
Mill River Union High School
Millers Run School
Milton Middle School
Milton Senior High School
Missisquoi Valley Union High School
Molly Stark School
Monkton Central School
Montgomery Elementary
Montpelier High School
Mosiac Learning Center
Mount Snow Academy
Mt. Abraham Union High School
Mt. Anthony Senior Union High School
Mt. Anthony Union Middle School
Mt. Holly School
Mt. Mansfield Academy
Mt. Mansfield Union High School
Mt. Saint Joseph Academy
Neshobe School
New School of Montpelier
Newark School
Newton School
North Country Union High School
North Country Union Junior High School
North County Career Center
Northfield Middle/High School
Northwest Career and Technical Center
Northwest Primary School
Okemo Mountain School
Orange Center School
Orford Schools
Orleans Elementary
Otter Valley Union High School
Oxbow Union High School
Pacem School
Patricia Hannaford Careetr Center
Peoples Academy
Peoples Academy Middle School
Poultney High School
Proctor Junior/Senior High School
Putney Central School
Putney School
Randolph Technical Career Center
Randolph Union High School
Readsboro Elementary
Rice Memorial High School
Richford Junior/Senior High School
Rivendell Academy
River Bend Career Center
River Valley Technical Center
Riverside Middle School
Robinson School
Rock Point School
Rutland Area Christian School
Rutland Middle School
Rutland Senior High School
Saint Albans City Elementry
Sharon Academy
Shelburne Community School
Sheldon Academy
Sheldon Elementry
South Burlington High School
Spaulding Union High School
Springfield High School
St. Johnsbury Academy
St. Albans Town Educational Center
St. Johnsbury School
St. Michael Christian School
Stafford Technical Center
Stamford Elementary
Stowe High School
Stowe Middle School
Stratton Mountain School
Sutton Village School
SW VT Career Dev. Center
Swanton School
The Arlington School
The Compass School
The Mill School
Thetford Academy
Townshend Village School
Troy School
Twin Valley Middle High School
Twinfield Union School
Two Roads Academy
U-32 Middle & High School
Upper Valley Waldorf School
Vergennes Union High School
Vermont Academy
Vermont Commons School
Waits River Valley Union School
Walden School
Wallingford Village School
Weathersfield School
West Rutland School
Westford Elementary
White River Valley High School
White River Valley Middle School
Williamstown Middle/High School
Williston Schools
Windham Regional Career Center
Windsor School
Winooski High School
Winooski Middle School
Woodside Juvenile Rehabilitation Center
Woodstock Union Middle/High School
Virginia School
Please select...
Albemarle High School
Altavista Combined School
Charlottesville High School
Fluvanna County High School
Monticello High School
Renaissance School
Tandem Friends School
Templeton Academy DC
Washington School
Please select...
Cascade High School
Challenger High School
Garrison Middle School
Gateway Middle School
Heatherwood Middle School
Hidden River Middle School
Kamiak High School
Legacy High School
Monroe High School
Park Place Middle School
Pioneer Middle School
Sammamish High School
Sky Valley Education Center
Skyline High School
Walla Walla High School
West Virginia School
Please select...
Choice A
Choice B
Choice C
Wisconsin School
Please select...
Appleton Area School District
District Little Chute Area School District
Fond du Lac High School
Fox Valley Lutheran
Gibraltar High School
Greenville Middle School
Hortonville High School
Hortonville Middle School
Kaukauna Area School District
Kimberly Area School District,
Manitowoc Public School District
Menasha Joint School
Neenah Joint School District
Reedsville High School
Sevastopol
Southern Door High School
St. Francis Xavier Catholic High School
St. Mary Catholic
Sturgeon Bay High School
Wyoming School
Please select...
Choice A
Choice B
Choice C
Youth and Government Participation
Please select...
Yes
No
Do you participate in YMCA Youth and Government?
Survey Questions
Please respond to each of the Youth Civic Health Survey questions below. If you have any additional thoughts you'd like to offer on the civic health of your school or community, you can share them at the end of the survey:
Talking to and Spending Time with Family and Friends
In the past 12 months, how often did you talk to or spend time with friends and family?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Discussing Various Issues with Family and Friends
In the past 12 months, how often did you discuss political, societal, or local issues with friends or family?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Talking to and Spending Time with Neighbors
In the past 12 months, how often did you have a conversation or spend time with your neighbors?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Discussing Various Issues with Neighbors
In the past 12 months, how often did you discuss political, societal, or local issues with your neighbors?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Doing Favors for Neighbors
In the past 12 months, how often did you/your household and your neighbors do favors for each other such as lawn/property maintenance, house sitting, babysitting, lending tools, and other things to help each other.
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Doing Something Positive for the Neighborhood
In the past 12 months, did you get together with other people from your neighborhood to do something positive for your neighborhood or the community?
Yes
No
Interacting with Different Racial, Ethnic, or Cultural Backgrounds
In the past 12 months, how often did you talk to or spend time with people from a
racial, ethnic, or cultural background that is different than yours? This may have been
in person, over the phone, or through the internet or social media.
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Posting About Various Issues on Social Media
In the past 12 months, how often did you post your views
about political, societal, or local issues on the internet or social media?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Reading, Watching, or Listening to News
In the past 12 months, how often did you read, watch or listen to news or information about political, societal, or local issues?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Attending Public Meetings
In the past 12 months, did you attend a public meeting, such as a city council, school board, or zoning board meeting, to discuss a local issue?
Yes
No
Contacting a Public Official
In the past 12 months, did you contact or visit a public official – at any level of government – to express your opinion?
Yes
No
Choosing Services Based on Social or Political Values of Companies
In the past 12 months, did you buy or boycott products or services based on the political values or business practices of that company?
Yes
No
Voter Registration
States have different laws for how old you must be to register (or pre-register) to vote. When you become eligible, do you intend to register or pre-register to vote?
Yes, I'm already registered or pre-registered
Yes, I plan on registering or pre-registering when I become eligible
No
Does your participation in Youth and Government make you more likely to register to vote?
Please select...
Yes
No
Did your participation in Youth and Government encourage you to register to vote?
Please select...
Yes
No
Voting
Do you plan on voting in the next presidential election in 2024?
(You must be 18 years old on or before Tuesday, November 5th, 2024)
Yes, I plan on voting.
I will be old enough to vote, but do NOT plan on voting.
I will be old enough to vote, but I'm unsure if I will vote.
I won't be old enough to vote yet.
Does your participation in Youth and Government make you more likely to vote in the future?
Please select...
Yes
No
Belonging to Groups
In the past 12 months, did you belong to any groups, organizations, or associations in your school or community (clubs, teams, houses of worship, causes, etc.)?
Yes
No
Number of Groups
How many groups, organizations, or associations in your school or community would you say you have belonged to over the past 12 months?
Please select...
None
1
2
3
4
5 or more
Volunteering
In the past 12 months, did you spend any time volunteering for any organization or association?
Yes
No
How Often You Volunteer
How often did you volunteer?
1 - Basically every day
2 - A few times a week
3 - A few times a month
4 - Once a month
5 - Less than once a month
6 - Not at all
Volunteering Hours in a Year
In the past 12 months, approximately how many hours (total over the entire 12 months) did you volunteer?
Please select...
0-5 hours
5-10 hours
10-25 hours
25-50 hours
50-100 hours
100 or more hours
Addressing an Issue in Your School or Community
If you wanted to help address an issue or problem in your school or community, how prepared would you feel to:
A. Research and learn more about the issue
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
research and learn more about the issue?
Please select...
No Impact
Some Impact
Significant Impact
B. Come up with a plan to take action
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
come up with a plan to take action?
Please select...
No Impact
Some Impact
Significant Impact
C. Recruit others to join your efforts
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
recruit others to join your efforts?
Please select...
No Impact
Some Impact
Significant Impact
D. Connect with groups/organizations that care about the issue
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
connect with groups/organizations that care about the issue?
Please select...
No Impact
Some Impact
Significant Impact
E. Start a petition on the issue and gather signatures
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
start a petition on the issue and gather signatures?
Please select...
No Impact
Some Impact
Significant Impact
F. Schedule and host a meeting on the issue
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
schedule and host a meeting on the issue?
Please select...
No Impact
Some Impact
Significant Impact
G. Speak publicly on the issue in front of an audience
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
speak publicly on the issue in front of an audience?
Please select...
No Impact
Some Impact
Significant Impact
H. Convince someone who disagrees with your position on the issue to change their mind
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
convince someone who disagrees with your position on the issue to change their mind?
Please select...
No Impact
Some Impact
Significant Impact
I. Share your opinion with a local news/media outlet
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
share your opinion with a local news/media outlet?
Please select...
No Impact
Some Impact
Significant Impact
J. Contact a local official about the issue
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
contact a local official about the issue?
Please select...
No Impact
Some Impact
Significant Impact
K. Propose changes to rules, policies, or laws related to the issue
1 - Not Prepared
2 - Slightly Prepared
3 - Somewhat Prepared
4 - Well Prepared
5 - Very Prepared
Does your participation in Youth and Government have any impact on how prepared you feel to
propose changes to rules, policies, or laws related to the issue?
Please select...
No Impact
Some Impact
Significant Impact
Additional Thoughts
Are there any additional thoughts you want to share about the civic health of your school or community?
Participant Feedback
As a participant in your state's YMCA Youth and Government program, please complete your survey by providing your feedback on the questions below:
Program Recommendation
As a program participant, on a scale of 0 (Not Likely) to 10 (Very Likely), how likely are you to recommend the Youth and Government program to a friend or peer?
0
1
2
3
4
5
6
7
8
9
10
Program Impact
On a scale of 0 (Least Impactful) to 10 (Most Impactful), how does your experience in the Youth and Government program compare to your other extracurricular experiences and commitments?
0
1
2
3
4
5
6
7
8
9
10
Personal Growth
Has your participation in the Youth and Government program helped you grow in any of the following areas?
Critical Thinking
Please select...
No Growth
Some Growth
Significant Growth
Research Skills
Please select...
No Growth
Some Growth
Significant Growth
Public Speaking
Please select...
No Growth
Some Growth
Significant Growth
Written Communication
Please select...
No Growth
Some Growth
Significant Growth
Relationship Building
Please select...
No Growth
Some Growth
Significant Growth
Collaborative Problem-Solving
Please select...
No Growth
Some Growth
Significant Growth
Time Management
Please select...
No Growth
Some Growth
Significant Growth
Emotional Management
Please select...
No Growth
Some Growth
Significant Growth
Future Plans
How has your participation in the Youth and Government program impacted your future plans?
College/Future Educational Plans
Please select...
No Impact
Some Impact
Significant Impact
Career Path & Professional Goals
Please select...
No Impact
Some Impact
Significant Impact
Remaining an Active Voter
Please select...
Less Likely
No Impact
More Likely
Running for Elected Office
Please select...
Less Likely
No Impact
More Likely
Most Important Program Experience
Finally, what would you consider to be the most important/impactful experience you've had while participating in the Youth and Government program?