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Ophelia's Place Outreach Survey II is a survey designed to help gather information about ways in
which Ophelia's Place can increase accessibility for all girls in our community.
Middle School Age
1. What is your age?
2. What is your ethnic identity? (Please mark all that apply.)
American Indian or Alaskan Native
Asian or Pacific Islander
Black or African American
Latina
White
Bi-racial or Multi-Racial
Other (please specify)
3. Please write all languages spoken in your home.
4. Please write your postal zip code.
5. Have you heard of Ophelia's Place before?
Yes
No
Ophelia's Place offers girls empowerment services to any girl between the ages of 10-18. Some of these services include: after school
drop-in, therapy, school presentations, girl's empowerment groups, skill building classes and summer camps. Popular skill building
programs may include: cooking class, anime club, art classes and girl's rock jam sessions.
6. How important are Ophelia's Place services to you?
Very important
Somewhat important
Not important
Unsure
For the purpose of this survey, "girls or women of color" are defined as individuals who identify as Non-White.
7. If you identify as a girl of color, what services do you feel would be helpful for you?
All female sex education
A safe place to talk about family, friend, and intimate relationships
Girls empowerment services offered in Spanish
Girl's group designed for young women of color
Counseling services
Other (please specify)
8. If you identify as a girl of color, what is the likelihood of you coming to Ophelia's Place?
Very likely
Somewhat likely
Not likely
Unsure
9. In your opinion, what is the easiest way to receive information about Organizations like Ophelia's Place?
Facebook
Twitter
Text messages
Word of mouth
School presentations
School counselor
Tabling events
Radio advertisements
10. If a Spanish speaking family or individual counselor was available at Ophelia's Place would you seek
out counseling services in Spanish?
Yes
No
Unsure
11. How important is it for you to be able to get support from another woman of color?
Very important
Somewhat important
Not important
Doesn't matter
12. Have you heard of Young Amazing Woman of Color (YAWOC) groups offered by Ophelia's Place?
Yes
No
Other (please specify)
13. Are there any reasons that you wouldn't want to come to Ophelia's Place?
Transportation (not having a way to get there)
Not enough information about Ophelia's Place
Not knowing anyone
Parent/Guardian permission
Please write any other activities that you would like to see offered at Ophelia's Place.

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OutreachSurveyMiddleSchool-2

  • 1. Ophelia's Place Outreach Survey II is a survey designed to help gather information about ways in which Ophelia's Place can increase accessibility for all girls in our community. Middle School Age 1. What is your age? 2. What is your ethnic identity? (Please mark all that apply.) American Indian or Alaskan Native Asian or Pacific Islander Black or African American Latina White Bi-racial or Multi-Racial Other (please specify) 3. Please write all languages spoken in your home. 4. Please write your postal zip code. 5. Have you heard of Ophelia's Place before? Yes No Ophelia's Place offers girls empowerment services to any girl between the ages of 10-18. Some of these services include: after school drop-in, therapy, school presentations, girl's empowerment groups, skill building classes and summer camps. Popular skill building programs may include: cooking class, anime club, art classes and girl's rock jam sessions.
  • 2. 6. How important are Ophelia's Place services to you? Very important Somewhat important Not important Unsure For the purpose of this survey, "girls or women of color" are defined as individuals who identify as Non-White. 7. If you identify as a girl of color, what services do you feel would be helpful for you? All female sex education A safe place to talk about family, friend, and intimate relationships Girls empowerment services offered in Spanish Girl's group designed for young women of color Counseling services Other (please specify) 8. If you identify as a girl of color, what is the likelihood of you coming to Ophelia's Place? Very likely Somewhat likely Not likely Unsure 9. In your opinion, what is the easiest way to receive information about Organizations like Ophelia's Place? Facebook Twitter Text messages Word of mouth School presentations School counselor Tabling events Radio advertisements
  • 3. 10. If a Spanish speaking family or individual counselor was available at Ophelia's Place would you seek out counseling services in Spanish? Yes No Unsure 11. How important is it for you to be able to get support from another woman of color? Very important Somewhat important Not important Doesn't matter 12. Have you heard of Young Amazing Woman of Color (YAWOC) groups offered by Ophelia's Place? Yes No Other (please specify) 13. Are there any reasons that you wouldn't want to come to Ophelia's Place? Transportation (not having a way to get there) Not enough information about Ophelia's Place Not knowing anyone Parent/Guardian permission Please write any other activities that you would like to see offered at Ophelia's Place.