YWLA 2016-17 MS Needs Assessment 1st 6 wks
The YWLA Counseling Department and Girls Inc. want to hear from you. Please honestly respond to each of the statements below and mark the most appropriate answer choice for you. Your responses will let us know what is important to you and what types of programs we can offer to assist you as you navigate through middle school at YWLA.
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What is your student ID #?
What grade are you in? *
Required
Answer each statement and check how true it is. I need help with the following PERSONAL concerns:   *
Yes
No
Making friends
Fitting in at school
Dealing with peer pressure
Dating or relationship issues
Feeling sad or depressed
Dealing with anger
Feeling stressed
Handling teasing or being bullied
Grief over the loss of a family member or loved one
Anger management
Feeling anxious
Skills for resolving conflict
Feeling Suicidal
I need help with the following SCHOOL concerns. *
Yes
No
Being Organized
Improving my study skills
Improving test taking skills
Time managment skills
Please check yes or no to the following statements. *
Yes
No
I know who my counselor is.
My counselor is available to me when I need to see her.
There is at least one person at school that I feel believe cares about my success.
Please check if you agree in the following statements: *
Yes
No
I am involved in activities outside of school
I understand why I need a good education
I will attend a four year college
My teachers help me when I have questions
I like coming to school
I enjoy my classes and they are interesting.
Have you heard of Girls Inc.?
If so, what is your favorite part of Girls Inc.?
What topics would you like Girls Inc. to help you with?
Do you intend to participate in the after school program this year? *
Required
If you choose to participate, which days will you attend?
Did you participate in the after school program last year?
What is your favorite after school activity?
If you could choose an afterschool activity for YWLA, what would it be?
Please list any concerns or needs that YOU PERSONALLY would like your counselor to help you with.
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