Questionnaire

Victory Over Violence
Emergency Teen Shelter
Questionnaire

Age:

Gender: Male: Female:

Location:

1) Where did you hear about the Victory Over Violence Emergency Teen Shelter? Check all boxes that apply:

School Friend Radio TV Other:

2) Do you think there is a need for an Emergency Teen Shelter?

Yes No I Don't Know

3) Do you know of anyone who needs the use of the Emergency Teen Shelter?

Yes No

4) Is there anything you feel that would prevent teens from using the Emergency Teen Shelter? If yes, what?

5) Have you heard of the Victory Over Violence "Let's Talk About It" groups?
Yes No If yes, where?
School Friend Radio TV Other:

6) Do you think there is a need for a "Let's Talk About It" groups?

Yes No I Don't Know

7) Do you know of anyone who needs the use of the "Let's Talk About It" groups?

Yes No

8) Is there anything you feel that would prevent teens from using "Let's Talk About It" groups? If yes, what?

9) If you have any further comments on any programs we provide or about the webpage in general, list them below:

10) If you have any questions, list them below:

All answers pertaining to the questionnaire above are kept confidential.

Thank you for your participation in this survey.
Sincerely, the Victory Over Violence Emergency Teen Shelter Program.

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