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LA CIMA EXISTS TO IMPART LEADERSHIP AND LIFE SKILLS TO LATINX YOUTH
LA CIMA EXISTE PARA INSPIRAR LIDERAZGO Y HABILIDADES DE LA JUVENTUD LATINA.
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La Cima Washington
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Student Voice
This student survey will take approximately 15 minutes.
Name
*
First Name
Last Name
School - Escuela
*
Email Address
*
Date of Birth - Fecha de Nacimiento
*
MM
DD
YYYY
Age
*
10
11
12
13
14
15
16
17
18
19
20
Gender
*
Male - Hombre
Female - Mujer
Grade - Nivel
*
6
7
8
9
10
11
12
GPA - Grade Point Average
40 Developmental Assets - 40 Elementos Fundamentales del Desarrollo
*
1. Family support: My family life provides high levels of love and support.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
2. Positive family communication: I communicate positively with my parent(s), and I am willing to seek advice from them.
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Thank you!