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How did you hear about this site?
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If Other please specify:
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What is your age?
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Less than 13
13
14
15
16
17
18
Parent or Guardian
What is your income?
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Less than $10,000
$10,001 - $25,000
$25,001 - $40,000
$40,001 - $70,000
$70,001 - $100,000
Greater than $100,000
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Student's school
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Fairfield
Rodriguez
Sem Yeto
Public Safety Academy
Armijo
What are the most serious problems in your school?
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Select
School security issues
lack of resources
Lack of parent involvement
Student behavior
Staff behavior
Violence
After school activities
Other
Why do you believe this is a problem?
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Do you or your student feel safe at school? Why or why not? What would you like to see change?
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Which of the following issues involving teens do you think most concerns teens in your community? Comment
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What would you like to see change in your community?
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Would you like to Volunteer?
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Yes
No
Maybe
If interested in volunteering, we recommend you complete the form on the volunteer page so that all responses will remain anonymous.
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