NSA Mid-South Teen Center

NSA Mid-South Teen Center

Teens Only This Section

How old are you?

	11/12	13/14	15/16	17/18

Are you male of female?

	male	female

Where do you live?

	off base	on base South	on base North

What is your race?

  African American
  Native American
  Caucasian
  Asian

  American Indian
  Latino
  Other (includes multiple choices)

Have you been to the Teen Center?

	yes	no

Teens Only: Please indicate your level of agreement or disagreement with the following items.

	Not True	Not to Somewhat True	Somewhat True	Somewhat True to True	True
	1	2	3	4	5
I use my outside of school time productively.
Spending time with friends is important to me.
I like being in a group.
I get bored easily.
Being involved in my community is important to me.
The Teen Center needs some rules.
I like to be in charge.
The Teen Center offers activities I enjoy.
I can get to the Teen Center easily.
The Teen Center is open hours that are good for me.
I think the Teen Center is a cool place.
Five dollars per month is a fair price to go to the Teen Center.
I participate in other organized activities out of school that keep me from using the Teen Center.
I know other people who might use the Teen Center.

Parents Only This Section

I have child(ren) ages:

	11/12	13/14	15/16	17-18

My child(ren) are:

	Male	Female	I have both

Where do you live?

	Off base	On base South	On base North

Our family is (mark all that apply):

  African American
  Native American
  Caucasian
  Asian

  American Indian
  Latino
  Other (includes multiple choices)

I have been / never been to the Teen Center.

	Been	Never Been

Parents Only: Please indicate your level of agreement or disagreement with the following items.

	Not True	Not to Somewhat True	Somewhat True	Somewhat True to True	True
	1	2	3	4	5
My child uses outside of school time productively.
The Teen Center offers activities that my child would enjoy.
My child can get to the Teen Center easily.
I think the Teen Center is a safe place.
Five dollars per month is a fair price for my child to go to the Teen Center.
My child participates in organized activities out of school that keeps him/her from using the Teen Center.