Parent Questionnaire

The information collected will be used to share our story with community leaders, volunteers, club staff, club members and donors. Collecting and publishing Boys & Girls Clubs of Tracy success stories and the impact our Clubs have on our youth and their families, will help us to garner more community support for our movement. Your participation will greatly increase our efforts!

Please take a moment and share your success story about the Boys & Girls Clubs of Tracy. Together we can help every child reach their full potential to BE GREAT. Please note that your story may show up in print on our website, newsletter, or printed marketing materials.

Thank you for your GREAT participation.

1. Please complete the following:

*First Name *Last Name *Email Address *Phone Number

Yes, I would like to receive e-mail form Boys & Girls Clubs of Tracy Yes, I would like to receive postal mail for Boys & Girls Clubs of Tracy

2. Child's Full Name

3. Club Your Child Attends

4. Age of your Child

5. Number of Years your Child has attended the Club?

6. Why is the Boys & Girls Club important to you?

7. What have your children gained from belonging to the Club?

8. Where do you think your child would go after school if there were no Boys & Girls Club?

9. What is your child’s favorite thing to do at the Club?

10. What is your child’s favorite thing to do at the Club?

11.Number of Children that Attend the Club from Your Family?