Appendix 5: Follow-up Youth Survey
S ummer of Innovation Youth Survey (Follow-up)
Last summer you participated in NASA’s Summer of Innovation! To improve this program for the future, all students who attended this program are being asked to complete a survey. There are no “right” or “wrong” answers to any of the questions. We want your honest opinions. It should take about 6 minutes to complete the questions. Thank you very much for your help!
NASA and its research team follow strict rules to make sure that only they will see your answers to this and future surveys for this program, except as required by law. No report will use your name or describe you in any way that could identify you.
If you wish to participate in this survey, please continue. Return your completed survey in the self-addressed stamped envelope.
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 U.S.C. § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget control number. The OMB control number for this collection is <insert number and expiration date>. Return your completed survey in the self-addressed stamped envelope. We estimate that it will take about 6 minutes to read the instructions, gather the facts, and answer the questions. You may send comments on our time estimate above to: by email to [email protected] or by mail to NASA Office of Education, 4U18, 300 E Street SW, Washington, DC, 20546-0001.
NASA Privacy Policy - This notice provides NASA's policy regarding the nature, purpose, use and sharing of any information collected via this form. The information you provide on a NASA-issued form will be used only for its intended purpose, which is to improve NASA’s Summer of Innovation program based on participant feedback. Your responses will be made anonymous and aggregated for review by the Summer of Innovation program management. NASA will protect your information consistent with the principles of the Privacy Act, the e-Government act of 2002, the Federal Records Act, and as applicable, the Freedom of Information Act. Submitting information is strictly voluntary. By doing so, you are giving NASA (and its designated representatives) your permission to use the information for the intended purpose. If you do not want to give NASA permission to use your information, simply do not provide it. However, not providing certain information may result in NASA's inability to provide you with the information or services you desire. For additional information please visit NASA Privacy Policy and Important Notices at http://www.nasa.gov/about/highlights/HP_Privacy.html.
Tell NASA about yourself
Your first name: ______________________Your last name: ______________________________
What is your birthday (MM/DD/YEAR)?: Month: ___ Day:___ Year: ______
What grade level will you begin in fall 2013? 4th 5th 6th 7th 8th 9th Other: _____
Tell NASA about your Summer of Innovation experience
For questions 4 through 6, please respond in whole sentences.
What did you like best about Summer of Innovation?
If you were in charge, how would you change your Summer of Innovation experience?
Would you recommend that your friends participate in Summer of Innovation? Yes No
Please explain why or why not:
How much did participating in Summer of Innovation impact you?
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Not at All |
Slightly |
Moderately |
A Great Deal |
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1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
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1 |
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3 |
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3 |
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1 |
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3 |
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1 |
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3 |
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Tell NASA about your science activities in and outside of school
What science class are you currently taking?
Science or General Science
Life Science
Earth Science
Physical Science
Integrated or Coordinated Science
Other science course
I don’t know
None Skip to Question 10.
How much do you agree or disagree with the following statements about your current science class?
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Never |
Rarely |
Sometimes |
Often |
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1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
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1 |
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Which of the following activities are you participating in during this school year (2013-2014)? Check all that apply.
Science club
Science competition
Science camp, not including Summer of Innovation
Science study groups or a program where you were tutored in science
None of these
Since you participated in the Summer of Innovation, how often have you done the following science activities?
Activity |
Never |
Rarely |
Sometimes |
Often |
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1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
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1 |
2 |
3 |
4 |
11.5 Watch programs on TV about nature and discoveries |
1 |
2 |
3 |
4 |
Tell NASA your opinions about science
The next series of questions contain a number of statements about science. You will be asked what you think about these statements. There are no “right” or “wrong” answers. We just want your opinions. For this survey, the word “science” covers a broad range of topics, including space and planets, animals and plants, medicine, computer programming, and designing things like machines.
Please indicate the extent to which you agree or disagree with each of the following statements. Select ONE in each row.
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Strongly Disagree |
Disagree |
Agree |
Strongly Agree |
12.1 Science is something I get excited about |
1 |
2 |
3 |
4 |
12.2
I like to take things apart to learn more |
1 |
2 |
3 |
4 |
12.3 I like to participate in science projects |
1 |
2 |
3 |
4 |
12.4 I’d like to get a science kit as a gift (for example, a microscope, magnifying glass, a robot, etc.) |
1 |
2 |
3 |
4 |
12.5
I like to see how things are made (for |
1 |
2 |
3 |
4 |
12.6
I like to watch programs on TV about |
1 |
2 |
3 |
4 |
12.7 I am curious to learn more about science, computers or technology |
1 |
2 |
3 |
4 |
12.8 I like to work on science activities |
1 |
2 |
3 |
4 |
12.9 If I have kids when I grow up, I will take them to a science museum |
1 |
2 |
3 |
4 |
12.10 I would like to have a science or computer job in the future. |
1 |
2 |
3 |
4 |
12.11 I want to understand science (for example, to know how computers work, how rain forms, or how airplanes fly) |
1 |
2 |
3 |
4 |
12.12 I enjoy visiting science museums or zoos |
1 |
2 |
3 |
4 |
12.13
I get excited about learning about new |
1 |
2 |
3 |
4 |
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Strongly Disagree |
Disagree |
Agree |
Strongly Agree |
12.14 I like reading science magazines |
1 |
2 |
3 |
4 |
12.15
I pay attention when people talk about |
1 |
2 |
3 |
4 |
12.16 I am curious to learn more about cars that run on electricity |
1 |
2 |
3 |
4 |
12.17 I get excited to find out that I will be doing a science activity |
1 |
2 |
3 |
4 |
12.18 I enjoy reading science fiction books |
1 |
2 |
3 |
4 |
12.19 I like learning about science on the internet |
1 |
2 |
3 |
4 |
12.20 I like online games or computer programs that teach me about science |
1 |
2 |
3 |
4 |
12.21 Science is boring |
1 |
2 |
3 |
4 |
12.22 I do science-related activities that are not for schoolwork. |
1 |
2 |
3 |
4 |
12.23 I like science |
1 |
2 |
3 |
4 |
12.24 Science is one of my favorite subjects |
1 |
2 |
3 |
4 |
12.25 I take science only because I have to |
1 |
2 |
3 |
4 |
12.26 I take science only because it will help me in the future |
1 |
2 |
3 |
4 |
12.27 Before joining this program, I was interested in science and science-related things |
1 |
2 |
3 |
4 |
12.28 Before joining this program, I participated in science activities outside of school |
1 |
2 |
3 |
4 |
12.29 I like to design a solution to a problem. |
1 |
2 |
3 |
4 |
12.30 I like to be part of a team that designs and builds a hands-on project. |
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12.31 I’m curious to learn how to program a computer game. |
1 |
2 |
3 |
4 |
12.32 I like to design and build something mechanical that works. |
1 |
2 |
3 |
4 |
Thanks for taking the time to complete this survey!
Return your completed survey in the self-addressed stamped envelope.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | National Aeronautics and Space Administration |
Author | Jan Nicholson |
File Modified | 0000-00-00 |
File Created | 2021-01-30 |