Volunteer Report on the Match

Volunteer Name:
Little Name:
Age:
Gender:	Male Female
Programs:	Community-Based School-Based Boys & Girls Club
Orientation:	White Black Hispanic Asian Native American Other

We would like you to describe any changes you’ve observed in the below areas. It’s okay to indicate "don’t know" if you have no knowledge about change in a given area.

Question Definitions or mouse over question in the left column.

	Much Worse	A Little Worse	No Change	A Little Better	Much Better	Don't Know	Not A Problem
CONFIDENCE
1) Self-confidence
2) Able to express feelings
3) Can make decisions
4) Has interests or hobbies
5) Personal hygiene
6) Sense of the future
COMPETENCE
7) Uses community resources
8) Uses school resources
9) Academic performance
10) Attitude toward school
11) School preparedness (homework)
12) Class participation
13) Classroom behavior
14) Able to avoid delinquency
15) Able to avoid substance abuse
16) Able to avoid early parenting
CARING
17) Shows trust toward you
18) Respects other cultures
19) Relationship with family
20) Relationship with peers
21) Relationship with other adults