Arcitec Youth Pre-Assessment

Arcitec Youth Pre-Assessment

Welcome to the Arcitec Foundation Youth Pre-Assessment.. Your responses will play a crucial role in helping us gain insight into the needs, aspirations, and challenges of our youth. Your answers will be kept confidential and are instrumental in enhancing our programs and services. Parents/Guardians - some questions may require support to assist students in their responses. *This pre-assessment is designed for black boys ages 11-18.
Name*

First NameLast Name
Email*
example@example.com
City & State of Residence *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Age*
Date of Birth*

MonthDayYear
Date
What race/ethnicity best describes you?*

Black / African AmericanWhite / CaucasianAmerican Indian / Alaskan NativeHispanic / LatinoAsian / Pacific IslanderBiracialOther
Current School*
What grade are you in?*
How did you hear about this survey?

Social mediaWebsiteList person or other option
Self-Assessment Starts Below:

Thank you very much for taking this survey. Please answer all the questions as honestly as you can, and to the best of your ability. Remember that there are no right or wrong answers.
I have positive role models in my life.*

YesNo
If you answered 'Yes' to the previous statement, provide the name and/or relationship of the positive role model in your life.
I have a mentor.*

YesNo
Mentorship programs are readily available to youth in my community.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
How would I rate my friendships?*

I have friends I fully trust and who support me.There are some people in my life who don’t support me, and some who do.I really don’t have much support in my life.I have people in my life who are hostile and dangerous to me.
I have a sense of belonging and connection to my community.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
How would you rate your feelings of safety where you live?*

1

2

3

4

5

1 is Unsafe, 5 is Safe
I currently have or I've had a black male teacher?

TrueFalseOther
I have an adult (parent/guardian, tutor) in my life that helps me with my schoolwork and homework.*

YesNo
I have access to books and reading materials outside of school.*

YesNoNot sure
I have access to educational resources outside of school (ie. Tutoring, educational apps).*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
I was taught or learned how to budget and manage money.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
I know how to set and work towards my goals.*

1

2

3

4

5

1 is Need help, 5 is Expert
I feel confident in my ability to achieve my goals.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
I set goals for what I want to do, and who I want to become a few years from now.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
I know how to manage my time effectively.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
I want to go to college one day.*

YesNoMaybe
I have a plan on how to get to college.*

YesNo
I know what an entrepreneur is, and could explain it.*

YesNo
I would feel confident giving a speech in front of a crowd of 20 people or more.*

Not confident at allA little confidentConfidentVery confident
I know exactly what mental health means?*

YesNoNot sureI heard of it but don't know exactly what it means
I know how to handle stress, anxiety, or being uncomfortable in a healthy way.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
I know what emotional intelligence means.*

YesNoNot sure
I think sports and physical activities are important for health and well-being.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
I am aware of different (non-sport) career opportunities available to me .*

1

2

3

4

5

1 is Lack awareness, 5 is Fully aware
I understand the connection between sports and life skills, and could explain the difference.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
I believe I CAN make a positive impact on my community.*

YesNoNot sure
I know HOW to make a positive impact on my community.*

I doI do notSomewhatI would like to learn how to
I have opportunities to volunteer or help others in my community.*

1

2

3

4

5

1 is Never, 5 is Always
I am aware of my rights and responsibilities as a young person.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
I am familiar with the concept of self-empowerment.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
Is there anything else you'd like to share with us? Any specific challenges you face or support you'd like to receive from Arcitec Foundation?
Almost there...Thank You!

Thank you for taking the time to complete this assessment. Your input is invaluable to us. Together, we can make a difference. Click 'Submit' in the box below to finish.
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Arcitec Youth Pre-Assessment

Self-Assessment Starts Below:

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