Culmore Intermediate Youth Club
1.
Gender
Female
Male
Prefer Not To Say
2.
What is your ethnic background?
White or Caucasian
Black African
Black Caribbean
Asian
Traveller
Roma
Other (please specify)
3.
Do you consider yourself to have a disability?
Yes
No
Prefer not to say
4.
Please rate the following statements according to how important they are to you.
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Provision of opportunities for children and young people to support their physical and mental health
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Provision of support for children and young people to achieve and remain in education and training
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Encouraging children and young people to male positive choices preventing them from engaging in risk taking behaviours
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Culmore Youth Club should provide children and young people with opportunities to explore environmental and climate issues
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Culmore Youth Club allows children and young people to have a say on decisions and services that effect them.
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Culmore Youth Club ensures that children and young people have access to a wide range of activities and opportunities.
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
Culmore Youth Club provides children and young people with opportunities to meet and engage with people from different backgrounds
Unimportant
Not Really Important
Neither Important or Unimportant
Important
Very Important
5.
Day of the week most suitable
Monday
Tuesday
Wednesday
Thursday
Friday
6.
What time of day is most suitable?
5pm - 6.15pm
5.15pm - 6.30pm
5.30pm - 6.45pm
5.45pm - 7pm
6pm - 7.15pm
7.
As a young person, which is more important to you? (Choose 3)
Having somewhere to socialise
Having fun
Good friendships
Family Relationships
The cost of living or money problems
Help with bullying
Being happy at school
Mental Health and Wellbeing
Feeling safe in your community
Making good educational choices
Career/Job/Training Opportunities
None of the above
Other (please specify)
8.
Which of the following activities are you interested in taking part in?
Health and Wellbeing Programmes
Mentoring Programmes
Outdoor Learning
Leadership
Music
Homework Club
Volunteering Opportunities
Life Skills Programmes
Drama
Outdoor Activities in natural surroundings
Employability Skills
Environmental Programmes
Arts and Crafts
Sports and Fitness
Other (please specify)
9.
From the list below, please select what matters most to you about taking part in Culmore Youth Club.
A place to meet
Being able to express my views on things that matter to me in a safe space
Opportunities to take part in fun activities
Opportunities to take part in fun activities
Opportunities to discuss issues
Regular activities/programmes to take part in
Making friends and meeting new people
Support and advice from an adult I trust
Other (please specify)
10.
What activities/programmes could Culmore Youth Club provide that would be most helpful to you?
Health and Wellbeing
Mentoring Programmes/Opportunities
Outdoor Learning
Leadership
Music
Employment and interview training
Homework Clubs
Volunteering Opportunities
Life Skills Programmes
Drama
Outdoor Activities in natural surroundings
Mental and Emotional Health Programmes
Programmes that help with employment in the future
Environmental Programmes
Young Men’s/Young Women’s Programmes
Arts and Crafts
Sports and Fitness
Other (please specify)