Dear Student,
 
Thank you for taking this survey!  Your feedback is very important to us!  
 
I have been asked by the Dodge Foundation, a funder of your music program, to assess the impact of the program on participants.
 
Your individual responses will only be available to me as Dodge's external researcher. In other words, I will be the only one who knows what your responses are - no one else.  Responses by all students will be de-identified (your name will be removed) and aggregated (all responses will be merged together) before they are shared with Dodge Foundation staff and your program staff. 

Completing this survey is voluntary. You are not required to complete it.

If you have any questions and/or concerns, please feel free to contact me at dew16@caa.columbia.edu.
 
Thank you!
Deborah E. Ward, Ph.D.
External Researcher


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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Which program do you participate in?

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* 4. What grade are you in?

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* 5. What is your gender?

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* 6. What is your race and/or ethnicity? (Please select all that apply.)

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* 7. How many years have you participated in this program?

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* 8. Please tell us whether you AGREE or DISAGREE with the following statements ABOUT YOURSELF:

  Very strongly agree Strongly agree Agree Neutral (Neither Agree or Disagree) Disagree Strongly disagree Very strongly disagree
I like to create things.
I like new experiences.
I like to try new things.
I feel good about myself.
I am not afraid of making mistakes.
When I set a goal I do not give up.
I am very creative.
I think of myself as a musician.
I am very interested in the arts (dance, music, theater, visual arts, and/or media arts).
I think of myself as an artist.

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* 9. Please tell us whether you AGREE or DISAGREE with the following statements ABOUT YOURSELF:

  Very strongly agree Strongly agree Agree Neutral (Neither Agree or Disagree) Disagree Strongly disagree Very strongly disagree
I care how others are feeling.
I listen to others.
I am interested in learning about people from a different background.
People listen to what I have to say.
When I listen to music I become calm.
I am happy when I am at home.
I try to make others feel better.
I help my friends when they have a problem.
I am nice to others when they are having a bad day.
I am popular at school.
People like me.
My family loves me.
I am happy when I am at school.
My community values me.
I contribute to my community.

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* 10. Check the words that best describe you. (Please check all that apply.)

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* 11. What do you like to do during your free time? (Please check all that apply)

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* 12. Are any of your parents/guardians a professional artist or engage in the arts for fun? (e.g. Actor, Dancer, Musician, Painter, Photographer, Singer, Writer, etc.)

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* 13. Do any of your family members play an instrument or sing?

The next two questions are about identity. Identity refers to how you think about yourself and how you define yourself. Identity can refer to what you like to do, what you're good at (painter, musician, writer), your personality (funny, happy, shy, sad, confident, smart), labels (popular, liked, lonely, a leader), your gender, religion, race, or culture, etc...

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* 14. Has participating in the El Sistema program impacted your identity or how you think about yourself? If so, how?

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* 15. Please tell us which of these is important to your IDENTITY. In other words, which of these are important to how you think of yourself. (Please check all that apply.)

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* 16. Please tell us what you do to calm down when you are stressed and/or upset. (Check everything that you do.)

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* 17. What is your favorite thing about playing an instrument and/or singing?

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* 18. Please tell us what you like or do not like about your El Sistema program.

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* 19. Have you enjoyed your virtual music classes?

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* 20. Please indicate your level agreement with the following statements about your El Sistema program.

  Very strongly agree Strongly agree Agree Neutral (Neither Agree or Disagree) Disagree Strongly disagree Very strongly disagree
The El Sistema program helps me do better in school.
The El Sistema program helps me get to know new people.
The El Sistema program is a waste of my time.
The El Sistema program gives me a sense of belonging.
The El Sistema program is my favorite part of the day.
The El Sistema program staff care about me.
The El Sistema program staff care about my community.
The El Sistema program staff are welcoming to my family.
The El Sistema program is not part of my community.
The El Sistema program teaches music that is relevant to my culture.

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* 21. Please feel free to share below any additional thoughts about your El Sistema program.

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