Children: Our Ultimate Investment USA (COUI) - Teens & Toddlers Follow-up Questionnaire - 2013

Answers marked with a * are required.

Teens & Toddlers Follow-up Questionnaire - 2013

Thank you for completing this questionnaire. We are very interested in your views and opinions – there are no right or wrong answers. Your name and privacy will be respected and kept confidential.

1. Please enter the name you were using at the time that you were participating in the Teens & Toddlers Program as well as your birth date.
PLEASE INSERT YOUR BIRTH DATE IN THIS FORMAT: MM/DD/YYYY
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Full Name
Birth Date (MM/DD/YYYY)

2. How do you define your ethnicity?
PLEASE SELECT ALL THAT APPLY
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Latino / Hispanic / Mexican American / Chicano

Black / African American

Native American / Alaskan Native / American Indian

White / Anglo

Asian / Pacific Islander

Other (Please Specify)

3. What was your age when you participated in the Teens & Toddlers Program?
*

Other (Please Specify)

4. What school did you attend when you participated in the Teens & Toddlers Program?
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Phoenix High School

Pueblo de Los Angeles

Temescal Canyon High School

Soledad Enrichment High School

Education for the Entertainment Arts School

5. When did you participate in the Teens & Toddlers Program? Please select your best guess if you know the year but are unsure of the semester.
-Note that the Fall semester runs from Sept of one year through the end of that year and the Spring semester runs from after the 1st of the next year through to the last day of school in June-
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6. Please select all the answers that best describe your situation BEFORE you entered the T&T program.
*PLEASE CHECK ALL ANSWERS THAT APPLY TO YOU*
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I had NO previous children before I enrolled in the T&T program

I had NO previous pregnancies before enrolling in the program

I already HAD children before I enrolled in the T&T program

I was pregnant / impregnated someone before I enrolled in the T&T program

I was expecting a child during the program and I / she kept the child

I was expecting a child during the program and I / she did NOT keep the child

I became pregnant / impregnated someone during the program and I / she kept the child

I became pregnant / impregnated someone during the program and I / she did NOT keep the child

7. Please select the one answer the best describes your situation AFTER completing the Teens & Toddlers program.
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I am a female who has NOT become pregnant

I am a female who became pregnant but I didn’t have / keep the baby

I have become a mother

I am a male who has NOT gotten a girl pregnant

I am a male who has gotten a girl pregnant but she didn’t have / keep the baby

I have become a father

I was already a parent BEFORE the program but have NOT had additional children since

I was already a parent BEFORE the program and I HAVE had additional children since

8. Please give date(s) of any and all pregnancies or births (MM/DD/YYYY).
(If you have NOT been pregnant / impregnated or become a parent, please enter "NEVER" in the text box.)
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9. How much do you feel the T&T program has influenced your decision about the age at which you would like to have children?
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Not at all

Not much

Unsure

A little

A lot

10. How much do you feel the T&T program affected your practice of safe sex (using condoms)?
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Not at all

Not much

Unsure

A little

A lot

11. How much do you feel that doing the T&T program made a positive difference in your life?
*

Not at all

Not much

Unsure

A little

A lot

12. Overall how useful would you say the T&T program would be to other teenagers? *

Not at all

Not much

Unsure

A little

A lot

13. What do you think would be the ideal age for you to become a parent?
*

Under 16

16 - 18

18 - 20

20 - 22

22 - 24

Over 25

14. What was the most important thing(s) you learned from Teens & Toddlers?
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15. Are there any other thoughts or comments that you would like to make?


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