Inner-City Junior Board Survey

Name*

First NameLast Name

E-mail*

Phone Number

Area CodePhone Number

STUDENT PROGRAMMING

Please indicate whether you are interested in any of the following programs:

Would you like to be part of the Fundraising Committee/ Event Planning Committee?

YesNo

Tutoring (1 hours per week)

YesNo

Field Trips (3-4 hours on a Saturday, 3-4 times per year)

YesNo

Basketball Clinic (1-2 hours per week for 6 weeks)

YesNo

Holiday parties – Halloween, Christmas, Valentines, Easter, end of school year celebration (2-3 hours per event)

YesNo

Would you be available on the weekend?*

YesNo

Please add any comments/suggestions here:

We look forward to your involvement with our Inner-City Junior Board.