7 Leadership Survey with Additional COVID-19 Questions

Attachment B. Leadership Surveys

NCCC Leadership Development Baseline Questionnaire

[NOTE: questions 1-3 for Corps members only; comparison group participants begin with question 4]

OMB Control Number: 3045-0189 (Expires 12/31/2022)

Your Upcoming NCCC Service

This survey will start with a few questions about you and your upcoming service with NCCC.

1. What are the first four letters of your last name?*

If your last name has less than four letters, please add one or more Xs to the end of the name to fulfill the four letter requirement.

_________________________________________________

2. In which program will you serve?*

( ) NCCC Traditional GO TO Q5

( ) NCCC FEMA Corps GO TO Q3

3. Was it your first choice to join FEMA Corps?*

( ) Yes

( ) No

NOTE: Corps members continue with question 5; COMPARISON GROUP participants begin with question 4

4. There are many reasons why individuals who have been accepted to serve with NCCC decide not to join. NCCC is interested in understanding the reason applicants may decide not to join NCCC after receiving an acceptance letter. For each of the reasons below please indicate whether it contributed to your decision not to serve with NCCC?*

[response option Yes No]

1. I am going back to school

2. I found a job / I am working

3. I will not be earning enough money as a NCCC member

4. I am concerned about my ability to do some physical activities

5. I have difficulty doing some activities because of a physical, mental, or emotional condition

6. I need to care for a family member or close friend

7. I am joining the military

8. I am going to serve with Peace Corps

9. I am going to serve with another AmeriCorps program (ASN, VISTA)

10. NCCC has too much structure / too strict

Other reason you decided not to join NCCC, please explain (please provide any additional explanation you would like to share about your decision not to serve with NCCC; if this decision is tied to the coronavirus pandemic, please explain it here)

5. How did you hear about AmeriCorps NCCC? [Check all that apply] *

[ ] a. From an AmeriCorps NCCC or FEMA Corps representative at a career fair or presentation.

[ ] b. From volunteering alongside an AmeriCorps NCCC or FEMA Corps team.

[ ] c. From an AmeriCorps NCCC or FEMA Corps representative someplace other than a career fair, presentation, or volunteer activity.

[ ] d. From a friend or family member who served in AmeriCorps NCCC or FEMA Corps.

[ ] e. From a friend or family member who served in a different AmeriCorps or service program (e.g., ASN, VISTA).

[ ] f. From people in my social group who had or knew of NCCC members that served in their communities.

[ ] g. From a teacher, professor, school counselor, or advisor.

[ ] h. From my time serving with Job Corps.

[ ] i. From my time serving with YouthBuild.

[ ] j. From my time serving with Youth ChalleNGe.

[ ] k. From a news story.

[ ] l. From an advertisement.

[ ] m. From the AmeriCorps website.

[ ] n. From social media (Facebook, Twitter, Tumblr, LinkedIn, etc.).

[ ] o. After applying to/serving with a different service organization (Peace Corps, Teach for America, City Year, etc.).

[ ] p. FEMA representative, website, news coverage, or social media.

[ ] Other - Please specify: _________________________________________________*

6. Have you previously volunteered with AmeriCorps?*

( ) Yes GO TO Q7a-c

( ) No GO TO Q8

7a-c. With which AmeriCorps have you previously volunteered?*

	Yes	No
a. AmeriCorps State and National (ASN)	( )	( )
b. NCCC/FEMA Corps	( )	( )
c. VISTA	( )	( )

7d. What year was your most recent service?*

Year __________________

Don’ remember

7e.  For your most recent service, did you complete your service?*

( ) Yes

( ) No, left early/did not complete service

8. Have you previously volunteered with any other organizations [e.g., religious, educational, health related, other charitable organization]?*

( ) Yes

( ) No

9. There are many reasons why individuals want to volunteer with NCCC. For each reason listed below, please indicate how relevant this reason was in your decision to serve with AmeriCorps NCCC/FEMA Corps.*

	Not relevant	Somewhat relevant	Very relevant	Quite relevant
a. I want to try something new to find what direction I want to take in my career.	( )	( )	( )	( )
b. I want to gain leadership skills.	( )	( )	( )	( )
c. I want to gain professional skills / carpentry or construction skills / build my résumé.	( )	( )	( )	( )
d. I want to meet new people / make friends.	( )	( )	( )	( )
e. I want to have stable housing and other benefits.	( )	( )	( )	( )
f. I want to travel the country / I want to leave the town that I am living in right now.	( )	( )	( )	( )
g. There are not enough jobs where I live
h. I want to earn money for future college tuition.	( )	( )	( )	( )
i. I want to earn money to pay off student loans.	( )	( )	( )	( )
j. I want to take a break before college.	( )	( )	( )	( )
k. I want to take a break .while enrolled in college.	( )	( )	( )	( )
l. I want to take a break between college/grad school.	( )	( )	( )	( )
m. I want the opportunity to network with professionals in my field of interest.	( )	( )	( )	( )
n. I want to gain experience to serve in other AmeriCorps programs (eg., ASN, VISTA)	( )	( )	( )	( )
o. I want to gain experience to join the military	( )	( )	( )	( )
p. I want to gain experience to join the Peace Corps	( )	( )	( )	( )
q. I want to make a difference / serve my country.	( )	( )	( )	( )
r. I want to reduce social or economic inequality	( )	( )	( )	( )
s. NCCC will give me a sense of purpose.
t. I have a friend or family member who was applying or participating.	( )	( )	( )	( )
u. An AmeriCorps organization or one like it helped you (or a loved one) in the past.	( )	( )	( )	( )
v. I want to earn money / I needed to get a job.	( )	( )	( )	( )
w. NCCC was my only employment option.	( )	( )	( )	( )
x. My parents/guardians wanted me to join NCCC.	( )	( )	( )	( )
y. There was another reason I wanted to join NCCC.	( )	( )	( )	( )

9x. The other reason I wanted to join NCCC was:* (please provide any additional explanation you would like to share about your decision to apply to serve; if this decision is tied to the coronavirus pandemic, please explain it here)

____________________________________________

____________________________________________

____________________________________________

____________________________________________

10. What sources did you use to learn what your experience will be like as an AmeriCorps NCCC member? [Choose yes or no]*

	Yes	No
a. I spoke with an AmeriCorps NCCC or FEMA Corps representative at a career fair, presentation, or volunteer activity.	( )	( )
b. I spoke with an AmeriCorps NCCC or FEMA Corps representative someplace other than a career fair, presentation, or volunteer activity.	( )	( )
c. I spoke with a friend or family member who served in AmeriCorps NCCC or FEMA Corps.	( )	( )
d. I spoke with a friend or family member who served in a different AmeriCorps or other national service program.	( )	( )
e. I spoke with people in my social group who had or knew of NCCC members that served in their communities.	( )	( )
f. I spoke with a teacher, professor, school counselor, or advisor.	( )	( )
g. I read information on the AmeriCorps NCCC website.	( )	( )
h. I read information on social media (Facebook, Twitter, Tumblr, LinkedIn, Reddit, etc.).	( )	( )
i. I watched a video online
j. I read the AmeriCorps NCCC Member Handbook.	( )	( )
k. I used other sources to learn about the NCCC AmeriCorps member experience.	( )	( )

 10k. The other sources I used to learn about the NCCC AmeriCorps member experience include: *

_________________________________________________

11. The following statements reflect people’s thoughts about the NCCC experience. For each statement below please indicate if you believe the statement is true, not true, maybe true about the NCCC experience.

	No, this is not true	Yes, this is true	Maybe this is true
a. I always must conform to uniform standards when on duty.	( )	( )	( )
b. I am part of a team of 8-10 other members who share my values.	( )	( )	( )
c. I live in a dormitory that feels like being in the military.	( )	( )	( )
d. I have complete privacy when I am not on duty.	( )	( )	( )
e. I serve on projects that are away from the dormitory of my campus and must live, eat and work with my team all the time around the clock.	( )	( )	( )
f. I get to work in an office doing administrative duties.	( )	( )	( )
g. I travel all over the United States and meet a lot of people.	( )	( )	( )
h. I do my service projects between 9 am and 5 pm, and I have free time at night and on weekends to do the things I want to do.	( )	( )	( )
i. I can take time off anytime I want.	( )	( )	( )
j. I participate in physical training only when I want.	( )	( )	( )
k. I cannot take a part-time job or take night classes.	( )	( )	( )
l. I can choose what type of work or project I will be doing.	( )	( )	( )
m. I will have a formal structure and processes to guide me on how, what and when things need to be done.	( )	( )	( )
n. I believe that there are times the rules can be bent.	( )	( )	( )
o. I have heard other statements about the NCCC experience.	( )	( )	( )

11o. Other statements I have heard about the NCCC experience include: *

____________________________________________

____________________________________________

____________________________________________

____________________________________________

NCCC is interested in understanding your work skills, like how you gather and analyze information, motivate co-workers, and manage time as well as your belief about what contributes to successful employment. This section includes questions to better understand these work skills.

Member Skills

12. How much confidence do you have that you could:*

	No confidence at all	Very little confidence	Moderate confidence	Much confidence	Complete confidence
a. Plan, coordinate and manage meetings or events	( )	( )	( )	( )	( )
b. Deliver presentations	( )	( )	( )	( )	( )
c. Work with the media and public relations	( )	( )	( )	( )	( )
d. Manage a project	( )	( )	( )	( )	( )
e. Community outreach	( )	( )	( )	( )	( )
f. Recruit, manage or train volunteers	( )	( )	( )	( )	( )

13. How much confidence do you have that you could:*

	No confidence at all	Very little confidence	Moderate confidence	Much confidence	Complete confidence
a. Set priorities for multiple tasks	( )	( )	( )	( )	( )
b. Adapt to new situations	( )	( )	( )	( )	( )
c. Seek new information to learn new or better ways of doing things	( )	( )	( )	( )	( )
d. Follow through to complete assigned tasks	( )	( )	( )	( )	( )

This section of the survey asks about how you achieve your goals.

Achieving Goals

14. How much do you agree or disagree that each of the following statements describes you:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I am confident that I could deal efficiently with unexpected events.	( )	( )		( )	( )
b. Thanks to my resourcefulness, I know how to handle unforeseen situations.	( )	( )		( )	( )
c. I can solve most problems if I invest the necessary effort.	( )	( )		( )	( )
d. I can remain calm when facing difficulties because I can rely on my coping abilities.	( )	( )		( )	( )
e. When I am confronted with a problem, I can usually find several solutions.	( )	( )		( )	( )
f. If I am in trouble, I can usually think of a solution.	( )	( )		( )	( )
g. I can usually handle whatever comes my way.	( )	( )		( )	( )

This section of the survey asks your opinion about the importance and desirability of relationships between people of different background, how often you participate in group situations working out conflicts and sharing ideas, and the techniques you use to encouraging participation when in group situations.

Cultural Competency

15. How much do you agree or disagree that each of the following statements describes you:*

	Strongly disagree	Disagree	Agree	Strongly agree
a. I can verbally communicate my ideas to other people	( )	( )	( )	( )
b. I listen to other people’s opinions or position on an issue	( )	( )	( )	( )
c. I collaborate on projects as a team member to achieve a shared goal	( )	( )	( )	( )
d. I get along with other people in my work environment	( )	( )	( )	( )
e. I resolve conflicts through discussion and dialog	( )	( )	( )	( )
f. I treat other people with courtesy and respect	( )	( )	( )	( )

16.  How often do you do the following:*

	Never	Rarely	Sometimes	Often	Very Often
a. I try to understand other people’s ideas and opinions before arguing or stating my own.	( )	( )	( )	( )	( )
b. I try to present my ideas without criticizing the ideas of others.	( )	( )	( )	( )	( )
c. I encourage different points of view without worrying about agreement.	( )	( )	( )	( )	( )
d. I try to consider all points of view or possible options before forming an opinion or making a decision.	( )	( )	( )	( )	( )
e. I encourage the participation of other people and support their right to be heard.	( )	( )	( )	( )	( )
f. I help find solutions when unexpected problems arise.	( )	( )	( )	( )	( )

17. How much do you agree with the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. If people from different backgrounds took the time to understand each other, there wouldn’t be so many social problems.	( )	( )		( )	( )
b. I feel comfortable belonging to groups where people are different from me.	( )	( )		( )	( )
c. Diverse viewpoints bring creativity and energy to a work group.	( )	( )		( )	( )
d. Multicultural teams can be stimulating and fun.	( )	( )		( )	( )
e. People are more motivated and productive when they feel they are accepted for who they are.	( )	( )		( )	( )
f. Diversity brings many perspectives to problem-solving.	( )	( )		( )	( )
g. I feel comfortable in forming friendships with people who are different from me.	( )	( )		( )	( )

The questions in this section ask your opinions on contributing to public life and participating in solving public problems, and volunteer experience.

Participation in Solving Public Problems

18. How much do you agree or disagree with the following:*

	Strongly disagree		Disagree		Neither agree or disagree		Agree		Strongly agree
a. I feel a personal obligation to contribute in some way to my community.	( )	( )				( )		( )
b. I am actively involved in issues that positively affect my community.	( )	( )				( )		( )
c. I can make a difference in my community or neighborhood.	( )	( )				( )		( )
d. I am not active but plan to become active in issues that positively affect my community.	( )	( )				( )		( )
e. I feel I have the ability to make a difference in my community.	( )	( )				( )		( )
f. I try to find the time or a way to make a positive difference in my community.	( )	( )				( )		( )

19. If you found out about a problem in your community that you wanted to do something about, how well do you think you would be able to do each of the following:*

	I definitely could NOT do this	I probably could NOT do this	I'm not sure if I could do this	I probably could do this	I definitely could do this
a. Create a plan to address the problem	( )	( )	( )	( )	( )
b. Get other people to care about the problem	( )	( )	( )	( )	( )
c. Organize and run a meeting	( )	( )	( )	( )	( )
d. Express your views in front of a group of people	( )	( )	( )	( )	( )
e. Identify individuals or groups who could help you with the problem	( )	( )	( )	( )	( )
f. Express your views on the Internet or through social media	( )	( )	( )	( )	( )
g. Call someone on the phone you had never met before to get their help with the problem	( )	( )	( )	( )	( )
h. Contact an elected official about the problem	( )	( )	( )	( )	( )

Participation in Public Life

20. Are you eligible to vote in the state where you live?*

( ) Yes

( ) No, not eligible to vote

( ) Don't know

21. How likely are you to vote in future national/general elections?*

( ) Definitely will not vote

( ) Probably will not vote

( ) Probably will vote

( ) Definitely will vote

This is the final section of the survey. These questions are about you in order to help us better understand participants’ background and experiences.

Member Background and Experiences

22. Please select the highest level of education you have completed.*

( ) Middle school GO TO Q22

( ) Some high school, I do not have a diploma or certificate GO TO Q22

( ) High school diploma or GED

GO TO Q23

( ) Technical school / Apprenticeship certificate or degree

( ) Some college

( ) Associate’s degree

( ) Bachelor's degree

( ) Graduate degree

( ) Other - Write In (Required): _________________________________________________*

22. Do you plan to get a high school diploma or GED?*

( ) Yes

( ) No

( ) Not Sure

23. When were you born?*

Month: _________________________________________________

Year: _________________________________________________

24. What were you doing in the last six months?	Yes	No
a. Working in the private sector	( )	( )
b. Working in the nonprofit or social service sector	( )	( )
c. Working in the public/government sector	( )	( )
d. Attending high school	( )	( )
e. Attending a vocational/technical training program	( )	( )
f. Attending college	( )	( )
g. Attending graduate school	( )	( )
h. Engaged in another national service experience	( )	( )
i. Working in my own small business	( )	( )
j. I am not in school / taking a break from school
k. Working in food preparation and serving related occupations (e.g., waitress, server, cook, bar tender, food service, baker, deli clerk)
l. Working at a nonprofit or social entrepreneurship venture that I created	( )	( )
m. Serving in the military	( )	( )
n. Not working/unemployed – this means you did not have a job and you were actively looking for work	( )	( )
o. Other	( )	( )

24o. If other, please describe what you have been doing in the last six months.* (please provide any additional explanation of what you were doing that you would like to share; if w here)

____________________________________________

____________________________________________

____________________________________________

____________________________________________

25.  Do you consider yourself of Hispanic or Latino origin?*

( ) No

( ) Yes

26. What is your race? [Check all that apply]*

[ ] American Indian or Alaska Native

[ ] Asian

[ ] Black or African American

[ ] Native Hawaiian or Other Pacific Islander

[ ] White

Member Background and Experiences

27. In the last six months, what was your living arrangement?
 

	Yes	No
a. Live at home with one or more parents or guardians	( )	( )
b. Live with friend or relative and did not pay rent	( )	( )
c. Live in a dormitory on a college campus / off campus college housing	( )	( )
d. Live in an apartment or home where you paid rent	( )	( )
e. Live in a residential program (e.g., JobCorps, military housing)	( )	( )
f. Homeless, live in a motel or hotel room / live in boarding house, halfway house, or board and care facility	( )	( )
g. In (or aging out of) foster care or I lived with a relative through a state-supervised kinship or guardianship program	( )	( )
h. I have had other living arrangements. Please describe below.	( )	( )

27h. Other living arrangements: *(please provide any additional explanation of your living arrangements that you would like to share; if this living arrangement was affected by the coronavirus pandemic, pleaseexplain here)

____________________________________________

____________________________________________

____________________________________________

____________________________________________

28. Please check all of the following that previously applied or currently apply to you:*

	Yes	No
a. I speak a language other than English.	( )	( )
b. I returned to school after initially being expelled or dropped out
c. I left home and remained away without parental or guardian permission.	( )	( )
d. I was convicted of an offense as a juvenile or adjudicated as a juvenile offender.	( )	( )
e. I have a physical impairment that has a substantial impact on my ability to carry out day-to-day activities.	( )	( )
f. I have a mental impairment that has a substantial impact on my ability to carry out day-to-day activities.	( )	( )

Parent/Guardian Background

29.  What is this parent’s or guardian’s relationship to you?*

( ) Biological Mother

( ) Biological Father

( ) Adoptive Mother

( ) Adoptive Father

( ) Stepmother

( ) Stepfather

( ) Foster Mother

( ) Foster Father

( ) Female Partner of your Parent or Guardian

( ) Male Partner of your Parent or Guardian

( ) Grandmother

( ) Grandfather

( ) Other Female Relative

( ) Other Male Relative

( ) Other Female Guardian

( ) Other Male Guardian

( ) No Parent GO TO Q38

( ) I do not want to answer GO TO Q38

30.  What is the highest level of education completed by this parent/guardian?*

( ) Less than high school completion

( ) Completed a high school diploma, GED or alternative high school credential

( ) Completed a certificate or diploma from a school that provides occupational training

( ) Completed an Associate’s degree

( ) Completed a Bachelor’s degree

( ) Completed a Master’s degree

( ) Completed a Ph.D., M.D., law degree, or other high level professional degree

( ) Don't know

31.  Does this parent/guardian currently hold a job for pay?*

( ) Yes GO TO Q33

( ) No GO TO Q32

( ) Don't Know GO TO Q32

32.  Has this parent/guardian ever held a job for pay?*

( ) Yes

( ) No

( ) Don't Know

33. Do you have another parent or guardian in the same household?*

( ) Yes GO TO Q34

( ) No GO TO Q38

Parent/Guardian Background (Parent/Guardian 2)

34.  What is this parent’s or guardian’s relationship to you?*

( ) Biological Mother

( ) Biological Father

( ) Adoptive Mother

( ) Adoptive Father

( ) Stepmother

( ) Stepfather

( ) Foster Mother

( ) Foster Father

( ) Female Partner of your Parent or Guardian

( ) Male Partner of your Parent or Guardian

( ) Grandmother

( ) Grandfather

( ) Other Female Relative

( ) Other Male Relative

( ) Other Female Guardian

( ) Other Male Guardian

( ) I do not want to answer GO TO Q38

35.  What is the highest level of education completed by this parent/guardian?*

( ) Less than high school completion

( ) Completed a high school diploma, GED or alternative high school credential

( ) Completed a certificate or diploma from a school that provides occupational training

( ) Completed an Associate’s degree

( ) Completed a Bachelor’s degree

( ) Completed a Master’s degree

( ) Completed a Ph.D., M.D., law degree, or other high level professional degree

( ) Don't know

36.  Does this parent/guardian currently hold a job for pay?*

( ) Yes GO TO Q38

( ) No GO TO Q37

37.  Has this parent/guardian ever held a job for pay?*

( ) Yes

( ) No

( ) Don't Know

Final Questions About You

38. What is your gender?*

( ) Male

( ) Female

( ) Other - Write In (Required): _________________________________________________*

39. Have you served on active duty in the military *

( ) No

( ) Yes

40. Where do you currently live?*

City or town*: _________________________________________________

Zip code*: _________________________________________________

Contact information for the follow-up surveys

Thank you again for taking the time to participate in this survey.

Just to make sure we are able to contact you for the follow-survey, could you provide your contact information. We will protect all the information from the surveys and phone interviews. Your information will be (a) stored in a safe and secure manner and (b) only used for research and/or statistical purposes. It will only be shared with CNCS staff and external parties who require the PII to complete their work. You will only be contacted for the purpose of this study. Your participation is voluntary, you can end your participation at any time.

[COMPARISON GROUP will also include this text: We will use the contact information to send you your $20 gift card.]

First Name: ________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: ____________________________________

E-mail: ___________________________________

41. How would you prefer we contact you in the future?

1. Phone ____

2. Email ____

3. Mail ____

42. What is the best phone number, email address, or physical address where you can be reached?

________________________________________

Contact Information for Relative and Friend:

In order for the research team to reach you for the next survey, please answer the next two questions about how to find you.]

43. Is there a relative or friend, who does not live in this household, who will always know how to get in touch with you? The research team will only contact this person if it cannot locate you for the next survey.

NO.............................................................. 0 (END THE SURVEY)

YES............................................................. 1 (GO TO 44)

DON’T KNOW ............................................. 8 (END THE SURVEY)

Prefer not to answer ................................................... 9 (END THE SURVEY)

44. What is the name, address, and telephone number of that person?

First Name: ________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: (_____)__________________

Email: _________________________

45. What is this person’s relationship to you?

RELATIVE _________________ 2

NEIGHBOR ________________ 3

FRIEND ___________________ 4

OTHER (SPECIFY)___________________ 7

PREFER NOT TO ANSWER ................................................... 9

46. Is there another relative or friend, who does not live in this household, who will always know how to get in touch with you? The research team will only contact this person if it cannot locate you for the next interview.

NO.............................................................. 0 (END SURVEY)

YES............................................................. 1 (GO TO 47)

DON’T KNOW ............................................. 8 (END SURVEY)

REFUSED ................................................... 9 (END SURVEY)

47. What is the name, address, and telephone number of that person?

First Name: ______________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: (_____) ________________________

48. What is this person’s relationship to you?

RELATIVE (SPECIFY)_________________ 2

NEIGHBOR (SPECIFY)________________ 3

FRIEND (SPECIFY)___________________ 4

OTHER (SPECIFY)___________________ 7

PREFER NOT TO ANSWER ................................................... 9

NCCC Leadership Development First Follow-up Questionnaire

OMB Control Number: XXX (Expires XX/XX/XX)

COMPARISON GROUP ONLY ANSWERS Q1a to Q1e

CORPS MEMBERS BEGIN WITH Q1

1a. Since the last survey have you served with AmeriCorps?

1. Yes GO TO Q1b

2. No GO TO Q1c

1b. With which AmeriCorps program have you previously volunteered? [check all that apply]

1. AmeriCorps State and National (ASN)

2. NCCC/FEMA Corps

3. VISTA

1c. what year was your most recent service?

Year _______

Don’t remember

1d. For your most recent year of service, did you complete your service?

1. Yes

2. No not yet, I am still in service

3. No, left early/did not complete service

1e. Have you previously volunteered with other organization [e.g., religious, educational, health related, other charitable organization

1. Yes

2. No

[NOTE: ALL COMPARISON GROUP PARTICIPANTS GO TO Q16]

AmeriCorps NCCC Term of Service

1. Did you complete your AmeriCorps NCCC term of service?*

( ) Yes GO TO Q3b

( ) No GO TO Q2

Reasons for Ending Service Early

There are many reasons why Corps members end their service early. NCCC is interested in understanding your NCCC experience and the reasons you might wish to end your service before graduation.

2. For each of the reasons below please indicate whether it contributed to your decision to leave early?*

	Yes	No
a. I was dismissed by the program	( )	( )
b. I want to go back to school	( )	( )
c. I found a job / I will start working	( )	( )
d. I am not earning enough money / I need to earn more money to help my family pay the bills	( )	( )
e. I have a condition that substantially limits my ability to do some physical activities	( )	( )
f. I have a mental or emotional condition that limits my ability to do some activities	( )	( )
g. I need to care for a family member or close friend	( )	( )
h. I felt disrespected by the people in the program
i. I do not feel valued by people in the program
j. People in the program did not try to get to know me
k. I do not get along with my supervisor or leadership (team leader, unit leader, or site supervisor)	( )	( )
l. I do not get along with the other members on my team	( )	( )
m. I am not making friends with the other people on my team	( )	( )
n. I am not learning the skills I need for the career I want	( )	( )
o. I do not feel part of the team	( )	( )
p. I am not gaining any leadership skills	( )	( )
q. I am not making a difference in people’s live with the projects I was assigned	( )	( )
r. I am not getting to do the type of work I thought I would be doing	( )	( )
s. My parents/guardians have told me I can come home	( )	( )
t. The work I was assigned is not fulfilling	( )	( )
u. I do not like the type of housing	( )	( )
v. I am joining the military	( )	( )
w. I am going to serve with Peace Corps	( )	( )
x. I am going to serve with another AmeriCorps program (ASN, VISTA)	( )	( )
y. NCCC has too much structure / too strict	( )	( )
z. I do not have internet access to do my assignments
aa. I could not complete my assignments because I am homeless, live in a motel or hotel room / live in boarding house, halfway house, or board and care facility.
ab. Other reason for leaving, please explain	( )	( )

2z. Please explain reason for leaving:* (please provide any additional explanation you would like to share about your decision to end your service before graduation; if your decision is tied to the coronavirus pandemic, please explain here)

____________________________________________

____________________________________________

____________________________________________

____________________________________________

3. How likely are you to participate in another AmeriCorps NCCC term in the future?*

( ) Not at all likely

( ) Not likely

( ) Somewhat likely

( ) Very likely

( ) Extremely likely

3b. Overall, how satisfied are you with your NCCC experience?

( ) Completely satisfied

( ) Very satisfied

( ) Somewhat satisfied

( ) Not very satisfied

( ) Not at all satisfied

Motivation for serving/Wanting to serve with NCCC

An important part of the survey is to understand why individuals decide/wanted to volunteer with NCCC.

4. There are many reasons why individuals want to volunteer with NCCC. For each reason listed could you indicate how relevant this reason was in your decision to serve with AmeriCorps NCCC/FEMA Corps?*

For each reason listed could you indicate how relevant this reason was in your decision to serve with AmeriCorps NCCC/FEMA Corps?

Do you feel NCCC helped you achieve this?

Quite Relevant*

Very Relevant*

Somewhat Relevant*

Not Relevant*

Yes*

No*

Not Sure*

a. I want to try something new to find what direction I want to take in my career.

( )

( )

( )

( )

( )

( )

( )

b. I want to gain leadership skills.

( )

( )

( )

( )

( )

( )

( )

c. I want to gain professional skills / build my résumé.

( )

( )

( )

( )

( )

( )

( )

d. I want to meet new people.

( )

( )

( )

( )

( )

( )

( )

e. I want to have stable housing and other benefits.

( )

( )

( )

( )

( )

( )

( )

f. I want to travel the country / I want to leave the town that I am living in right now

( )

( )

( )

( )

( )

( )

( )

g. There are not enough jobs where I live

h. I want to earn money for future college tuition.

( )

( )

( )

( )

( )

( )

( )

i. I want to earn money to pay off student loans.

( )

( )

( )

( )

( )

( )

( )

j. I want to take a break before college.

( )

( )

( )

( )

( )

( )

( )

k. I want to take a break while enrolled in college.

( )

( )

( )

( )

( )

( )

( )

l. I want to take a break between college/grad school.

( )

( )

( )

( )

( )

( )

( )

m. I want the opportunity to network with professionals in my field of interest.

( )

( )

( )

( )

( )

( )

( )

n. I want to gain experience to serve in other AmeriCorps programs (eg., ASN, VISTA)

( )

( )

( )

( )

( )

( )

( )

o. I want to gain experience to join the military

( )

( )

( )

( )

( )

( )

( )

p. I want to gain experience to join the Peace Corps

( )

( )

( )

( )

( )

( )

( )

q. I want to make a difference / serve my country.

( )

( )

( )

( )

( )

( )

( )

r. I want to reduce social or economic inequality.

( )

( )

( )

( )

( )

( )

( )

s. NCCC will give me a sense of purpose

t. I have a friend or family member who was applying or participating.

( )

( )

( )

( )

( )

( )

( )

u. An AmeriCorps organization or one like it helped you (or a loved one) in the past.

( )

( )

( )

( )

( )

( )

( )

v. I want to earn money / I needed to get a job.

( )

( )

( )

( )

( )

( )

( )

w. NCCC was my only employment option.

w. My parents/guardians wanted me to join NCCC.

( )

( )

( )

( )

( )

( )

( )

x. . There was another reason I wanted to join NCCC

( )

( )

( )

( )

( )

( )

( )

4x. The other reason I wanted to join NCCC was: (please provide any additional explanation you would like to share about your decision to serve; if this decision is tied to the coronavirus pandemic, please explain it here)

____________________________________________

____________________________________________

____________________________________________

____________________________________________

NCCC Service Projects Experiences

The following questions ask about your service experience, service projects, and satisfaction with the NCCC program.

5. How do you feel about your NCCC service experience?*

GO TO Q6

( ) Very dissatisfied

( ) Dissatisfied

( ) Neither

GO TO Q7

( ) Satisfied

( ) Very satisfied

6. You stated that you are not satisfied, could you describe why you are not satisfied with your NCCC service experience?*

____________________________________________

____________________________________________

____________________________________________

____________________________________________

7. What is your recommendation to improve the NCCC service experience?*

____________________________________________

____________________________________________

____________________________________________

____________________________________________

8. Do you agree that it is important to have the opportunity to serve with members from diverse backgrounds?*

( ) Strongly disagree

( ) Disagree

( ) Neither agree or disagree

( ) Agree

( ) Strongly agree

NCCC Service Projects Experiences

9. People think of diversity in different ways such as for example, race, ethnicity, religion, political, economic, education, sexual orientation. How do you define diversity?*

____________________________________________

____________________________________________

____________________________________________

____________________________________________

10. NCCC has a strong commitment to retaining a diverse pool of diverse applicants through the year of service. What should NCCC do to attain this commitment?*

____________________________________________

____________________________________________

____________________________________________

____________________________________________

11. If a good friend or family member told you he or she was interested in joining NCCC, would you:*

( ) Advise against it

( ) Have second thoughts about recommending it

( ) Recommend it

( ) Strongly recommend it

12. Thinking about your NCCC service projects, please indicate how much you agree or disagree with each of the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I developed an understanding of the strengths of communities.	( )	( )		( )	( )
b. I can recognize solutions to challenges communities face.	( )	( )		( )	( )
c. I spent a lot of time doing meaningless “make work” tasks.	( )	( )		( )	( )
d. I felt defeated by the complexities of the problems that I worked on.	( )	( )		( )	( )

12b. Is there another statement you would like to add about your NCCC service projects?

1. Yes (Please write in the statement) [GO TO Q12c]

2. NO

12c. How do you feel about your statement? [response options: strongly agree, agree, neither agree or disagree, disagree, strong disagree]

13. Thinking about the people you interacted with in your NCCC team and in the communities you served, please indicate how much you agree or disagree with each of the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I was exposed to new ideas and ways of seeing the world.	( )	( )		( )	( )
b. I had an opportunity to interact with people who were different than me.	( )	( )		( )	( )
c. I re-examined my beliefs and attitudes about other people.	( )	( )		( )	( )
d. I re-examined my beliefs and attitudes about challenges communities face
e. I did not get along well with my supervisor or leadership (team leader, , unit leader, or site supervisor)	( )	( )		( )	( )
f. I did not feel value by the people in my team or group.	( )	( )		( )	( )
g. I felt that the people I worked with or lived with did not understand me.	( )	( )		( )	( )
h. I felt a sense of belonging on my team.	( )	( )		( )	( )
i. I felt accepted by my teammates.	( )	( )		( )	( )
j. I felt personally accepted in the communities in which I worked and served.	( )	( )		( )	( )
k. I get asked to contribute in planning social activities not directly related to my volunteer work.
l. I am told about informal social activities and events.
m. I am rarely invited to join other team members when they go out or to take a break.

14. Thinking about how work on NCCC projects affected your growth, please indicate how much you agree or disagree with each of the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I did things l never thought I could do.	( )	( )	( )	( )	( )
b. My service in NCCC helped me understand what my next steps are in terms of educational goals.	( )	( )	( )	( )	( )
c. My service in NCCC helped me understand what my next steps are in terms of career/professional goals.	( )	( )	( )	( )	( )
d. My service in NCCC helped me understand what my next steps are in terms of personal goals.	( )	( )	( )	( )	( )

15. How often has your NCCC team done the following:*

	Never	Rarely	Sometimes	Often	Very often
a. We discuss issues and problems and share ideas.	( )	( )	( )	( )	( )
b. We involve everyone and avoid favoritism.	( )	( )	( )	( )	( )
c. We can disagree and be different from one another.	( )	( )	( )	( )	( )
d. We take time to work out any conflicts.	( )	( )	( )	( )	( )

15a. Is there anything that you would like to share about your NCCC team?

1. Yes (write in your statement) [GO TO Q15b]

2. No

15b. For the statement you shared about your NCCC team, how often has the team done this? [response options: never, rarely, sometimes, often, very often]

NCCC is interested in understanding your work skills, like how you gather and analyze information, motivate co-workers, and manage time as well as your belief about what contributes to successful employment. This section includes questions to better understand these work skills.

Member Skills

16. How much confidence do you have that you could:*

	No confidence at all	Very little confidence	Moderate confidence	Much confidence	Complete confidence
a. Plan, coordinate and manage meetings or events	( )	( )	( )	( )	( )
b. Deliver presentations	( )	( )	( )	( )	( )
c. Work with the media and public relations	( )	( )	( )	( )	( )
d. Manage a project	( )	( )	( )	( )	( )
e. Community outreach	( )	( )	( )	( )	( )
f. Recruit, manage or train volunteers	( )	( )	( )	( )	( )

17. How much confidence do you have that you could:*

	No confidence at all	Very little confidence	Moderate confidence	Much confidence	Complete confidence
a. Set priorities for multiple tasks	( )	( )	( )	( )	( )
b. Adapt to new situations	( )	( )	( )	( )	( )
c. Seek new information to learn new or better ways of doing things	( )	( )	( )	( )	( )
d. Follow through to complete assigned tasks	( )	( )	( )	( )	( )

This section of the survey asks about how you achieve your goals.

Achieving Goals

 18. How much do you agree or disagree that each of the following statements describes you:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I am confident that I could deal efficiently with unexpected events.	( )	( )		( )	( )
b. Thanks to my resourcefulness, I know how to handle unforeseen situations.	( )	( )		( )	( )
c. I can solve most problems if I invest the necessary effort.	( )	( )		( )	( )
d. I can remain calm when facing difficulties because I can rely on my coping abilities.	( )	( )		( )	( )
e. When I am confronted with a problem, I can usually find several solutions.	( )	( )		( )	( )
f. If I am in trouble, I can usually think of a solution.	( )	( )		( )	( )
g. I can usually handle whatever comes my way.	( )	( )		( )	( )

This section of the survey asks for your opinion about the importance and desirability of relationships between people of different background, how often you participated in group situations working out conflicts and sharing ideas, and the techniques you use to encouraging participation when in group situations.

Cultural Competency

19. How much do you agree or disagree that each of the following statements describes you:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I can verbally communicate my ideas to other people	( )	( )		( )	( )
b. I listen to other people’s opinions or position on an issue	( )	( )		( )	( )
c. I collaborate on projects as a team member to achieve a shared goal	( )	( )		( )	( )
d. I get along with other people in my work environment	( )	( )		( )	( )
e. I resolve conflicts through discussion and dialog	( )	( )		( )	( )
f. I treat other people with courtesy and respect	( )	( )		( )	( )

20.  How often do you do the following:*

	Never	Rarely	Sometimes	Often	Very Often
a. I try to understand other people’s ideas and opinions before arguing or stating my own.	( )	( )	( )	( )	( )
b. I try to present my ideas without criticizing the ideas of others.	( )	( )	( )	( )	( )
c. I encourage different points of view without worrying about agreement.	( )	( )	( )	( )	( )
d. I try to consider all points of view or possible options before forming an opinion or making a decision.	( )	( )	( )	( )	( )
e. I encourage the participation of other people and support their right to be heard.	( )	( )	( )	( )	( )
f. I help find solutions when unexpected problems arise.	( )	( )	( )	( )	( )

21. How much do you agree with the following statements:*

	Strongly disagree	Disagree		Neither agree or disagree		Agree	Strongly agree
a. If people from different backgrounds took the time to understand each other, there wouldn’t be so many social problems.	( )	( )			( )		( )
b. I feel comfortable belonging to groups where people are different from me.	( )	( )			( )		( )
c. Diverse viewpoints bring creativity and energy to a work group.	( )	( )			( )		( )
d. Multicultural teams can be stimulating and fun.	( )	( )			( )		( )
e. People are more motivated and productive when they feel they are accepted for who they are here.	( )	( )			( )		( )
f. Diversity brings many perspectives to problem-solving.	( )	( )			( )		( )
g. I feel comfortable in forming friendships with people who are different from me.	( )	( )			( )		( )

This section of the survey asks about your opinions on contributing to public life and participating in solving public problems, and volunteer experience prior to NCCC.

Participation in Solving Public Problems

22. How much do you agree or disagree with the following:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I feel a personal obligation to contribute in some way to my community.	( )	( )		( )	( )
b. I am actively involved in issues that positively affect my community.	( )	( )		( )	( )
c. I can make a difference in my community or neighborhood.	( )	( )		( )	( )
d. I feel I have the ability to make a difference in my community.	( )	( )		( )	( )
e. I try to find the time or a way to make a positive difference in my community.	( )	( )		( )	( )

23. If you found out about a problem in your community that you wanted to do something about, how well do you think you would be able to do each of the following:*

	I definitely could NOT do this	I probably could NOT do this	I'm not sure if I could do this	I probably could do this	I definitely could do this
a. Create a plan to address the problem	( )	( )	( )	( )	( )
b. Get other people to care about the problem	( )	( )	( )	( )	( )
c. Organize and run a meeting	( )	( )	( )	( )	( )
d. Express your views in front of a group of people	( )	( )	( )	( )	( )
e. Identify individuals or groups who could help you with the problem	( )	( )	( )	( )	( )
f. Express your views on the Internet or through social media	( )	( )	( )	( )	( )
g. Call someone on the phone you had never met before to get their help with the problem	( )	( )	( )	( )	( )
h. Contact an elected official about the problem	( )	( )	( )	( )	( )

Contact information for the follow-up surveys

Thank you again for taking the time to participate in this survey.

Just to make sure we are able to contact you for the follow-survey, could you provide your contact information. We will protect all the information from the surveys and phone interviews. Your information will be (a) stored in a safe and secure manner and (b) only used for research and/or statistical purposes. It will only be shared with CNCS staff and external parties who require the PII to complete their work. You will only be contacted for the purpose of this study. Your participation is voluntary, you can end your participation at any time.

[COMPARISON GROUP will also include this text: We will use the contact information to send you your $20 gift card.]

First Name: ________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: ____________________________________

E-mail: ___________________________________

24. How would you prefer we contact you in the future?

1. Phone ____

2. Email ____

3. Mail ____

25. What is the best phone number, email address, or physical address where you can be reached?

________________________________________

Contact Information for Relative and Friend:

In order for the research team to reach you for the next survey, please answer the next two questions about how to find you.]

26. Is there a relative or friend, who does not live in this household, who will always know how to get in touch with you? The research team will only contact this person if it cannot locate you for the next survey.

NO.............................................................. 0 (END THE SURVEY)

YES............................................................. 1 (GO TO 27)

DON’T KNOW ............................................. 8 (END THE SURVEY)

Prefer not to answer ................................................... 9 (END THE SURVEY)

27. What is the name, address, and telephone number of that person?

First Name: ________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: (_____)__________________

Email: _________________________

28. What is this person’s relationship to you?

RELATIVE _________________ 2

NEIGHBOR ________________ 3

FRIEND ___________________ 4

OTHER (SPECIFY)___________________ 7

PREFER NOT TO ANSWER ................................................... 9

29. Is there another relative or friend, who does not live in this household, who will always know how to get in touch with you? The research team will only contact this person if it cannot locate you for the next interview.

NO.............................................................. 0 (END SURVEY)

YES............................................................. 1 (GO TO 30)

DON’T KNOW ............................................. 8 (END SURVEY)

REFUSED ................................................... 9 (END SURVEY)

30. What is the name, address, and telephone number of that person?

First Name: ______________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: (_____) ________________________

31. What is this person’s relationship to you?

RELATIVE (SPECIFY)_________________ 2

NEIGHBOR (SPECIFY)________________ 3

FRIEND (SPECIFY)___________________ 4

OTHER (SPECIFY)___________________ 7

PREFER NOT TO ANSWER ................................................... 9

NCCC Leadership Development Second Follow-up Questionnaire

[NOTE: COMPARISON GROUP BEGIN SURVEY WITH Q6]

OMB Control Number: XXX (Expires XX/XX/XX)

An important part of the survey is to understand why individuals decide to volunteer with NCCC.

Motivation for Volunteering

1. There are many reasons why individuals wanted to volunteer with NCCC. For each reason listed below could you indicate how relevant this reason was in your decision to serve with AmeriCorps NCCC/FEMA Corps?*

	For each reason listed could you indicate how relevant this reason was in your decision to serve with AmeriCorps NCCC/FEMA Corps?				Do you feel NCCC helped you achieve this?
	Quite Relevant*	Very Relevant*	Somewhat Relevant*	Not Relevant*	Yes*	No*	Not Sure*
a. I wanted to try something new to find what direction I wanted to take in my career.	( )	( )	( )	( )	( )	( )	( )
b. I wanted to gain leadership skills.	( )	( )	( )	( )	( )	( )	( )
c. I wanted to gain professional skills / build my résumé.	( )	( )	( )	( )	( )	( )	( )
d. I wanted to meet new people.	( )	( )	( )	( )	( )	( )	( )
e. I wanted to have stable housing and other benefits.	( )	( )	( )	( )	( )	( )	( )
f. I wanted to travel the country / I wanted to leave the town that I was living in at the time.	( )	( )	( )	( )	( )	( )	( )
g. There were not enough jobs where I live
h. I wanted to earn money for future college tuition.	( )	( )	( )	( )	( )	( )	( )
i. I wanted to earn money to pay off student loans.	( )	( )	( )	( )	( )	( )	( )
j. I wanted to take a break before college.	( )	( )	( )	( )	( )	( )	( )
k. I wanted to take a break while enrolled in college.	( )	( )	( )	( )	( )	( )	( )
l. I wanted to take a break between college/grad school.	( )	( )	( )	( )	( )	( )	( )
m. I wanted the opportunity to network with professionals in my field of interest.	( )	( )	( )	( )	( )	( )	( )
n. I wanted to gain experience to serve in other AmeriCorps programs (eg., ASN, VISTA)	( )	( )	( )	( )	( )	( )	( )
o. I wanted to gain experience to join the military	( )	( )	( )	( )	( )	( )	( )
p. I wanted to gain experience to join the Peace Corps	( )	( )	( )	( )	( )	( )	( )
q. I wanted to make a difference / serve my country.	( )	( )	( )	( )	( )	( )	( )
r. I wanted to reduce social or economic inequality.	( )	( )	( )	( )	( )	( )	( )
s. NCCC could give me a sense of purpose
t. I had a friend or family member who was applying or participating.	( )	( )	( )	( )	( )	( )	( )
u. An AmeriCorps organization or one like it helped you (or a loved one) in the past.	( )	( )	( )	( )	( )	( )	( )
v. I wanted to earn money / I needed to get a job.	( )	( )	( )	( )	( )	( )	( )
w. My parents/guardians wanted me to join NCCC.	( )	( )	( )	( )	( )	( )	( )
x. There was another reason I wanted to join NCCC	( )	( )	( )	( )	( )	( )	( )

1x. The other reason I wanted to join NCCC was: ____________________________________________

____________________________________________

____________________________________________

____________________________________________

NCCC Experience

2. Thinking about how work on NCCC projects affected your growth, please indicate how much you agree or disagree with each of the following statements:*

	Strongly disagree	Disagree	Agree	Neither agree or disagree	Strongly agree
a. My service in NCCC helped me to further my educational goals.	( )	( )	( )		( )
b. My service in NCCC helped me to further my career/professional goals.	( )	( )	( )		( )
c. My service in NCCC helped to further my personal goals.	( )	( )	( )		( )

Use of Education Award

3. How did you use your AmeriCorps education award?*

	Yes	No
a. To attend college	( )	( )
b. To repay student loans	( )	( )
c. To attend graduate school	( )	( )
d. To attend a technical or vocational training program	( )	( )
e. Transfer education award to a family member	( )	( )
f. I did not qualify to receive an education award	( )	( )
g. I did not use my education award	( )	( )
h. I have not yet used my education award, but I plan to use it	( )	( )

4. If you are working now, does your current job involve any of the organizations or AmeriCorps programs that you worked with during your AmeriCorps NCCC service?*

( ) Yes

( ) No

5. If a good friend or family member told you he or she was interested in joining NCCC, would you:*

( ) Advise against it

( ) Have second thoughts about recommending it

( ) Recommend it

( ) Strongly recommend it

[NOTE: COMPARISON GROUP BEGIN SURVEY WITH Q6]

Employment

6.  What are you doing now?

	Yes	No
a. Working in the non-profit sector	( )	( )
b. Working in the private sector	( )	( )
c. Working in government or in the public sector	( )	( )
d. Serving in the military	( )	( )
e. Self-employed	( )	( )
f. Looking for work	( )	( )
g. Staying at home to take care of a family or household member or for other reasons	( )	( )
h. Working as a supervisor or in a management capacity	( )	( )
i. Serving in another national service program (another AmeriCorps program, Senior Corps, NCCC, or VISTA project)	( )	( )
j. Serving with the Peace Corps	( )	( )
k. Engaging in other volunteer service	( )	( )
l. Making plans to attend school	( )	( )
m. Attending college or graduate school	( )	( )
n. Enrolled in a certificate, technical, or vocational program	( )	( )
o. I am doing something else that is not listed:	( )	( )

6v. Other (specify):*

____________________________________________

____________________________________________

____________________________________________

____________________________________________

7. Since the last survey have you served with?*

	Yes	No
a. AmeriCorps State and National (ASN)	( )	( )
b. NCCC/FEMA Corps	( )	( )
c. VISTA	( )	( )

7a. Since the last survey, have you volunteered with any other organizations [e.g., religious, educational, health related, other charitable organization

( ) Yes

( ) No

NCCC is interested in understanding your work skills, like how you gather and analyze information, motivate co-workers, and manage time as well as your belief about what contributes to successful employment. This section includes questions to better understand these work skills.

Skills

8. How much confidence do you have that you could:*

	No confidence at all	Very little confidence	Moderate confidence	Much confidence	Complete confidence
a. Plan, coordinate and manage meetings or events	( )	( )	( )	( )	( )
b. Deliver presentations	( )	( )	( )	( )	( )
c. Work with the media and public relations	( )	( )	( )	( )	( )
d. Manage a project	( )	( )	( )	( )	( )
e. Community outreach	( )	( )	( )	( )	( )
f. Recruit, manage or train volunteers	( )	( )	( )	( )	( )

9. How much confidence do you have that you could:*

	No confidence at all	Very little confidence	Moderate confidence	Much confidence	Complete confidence
a. Set priorities for multiple tasks	( )	( )	( )	( )	( )
b. Adapt to new situations	( )	( )	( )	( )	( )
c. Seek new information to learn new or better ways of doing things	( )	( )	( )	( )	( )
d. Follow through to complete assigned tasks	( )	( )	( )	( )	( )

This section of the survey asks about how you achieve your goals.

Achieving Goals

 10. How much do you agree or disagree that each of the following statements describes you:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I am confident that I could deal efficiently with unexpected events.	( )	( )	( )		( )
b. Thanks to my resourcefulness, I know how to handle unforeseen situations.	( )	( )	( )		( )
c. I can solve most problems if I invest the necessary effort.	( )	( )	( )		( )
d. I can remain calm when facing difficulties because I can rely on my coping abilities.	( )	( )	( )		( )
e. When I am confronted with a problem, I can usually find several solutions.	( )	( )	( )		( )
f. If I am in trouble, I can usually think of a solution.	( )	( )	( )		( )
g. I can usually handle whatever comes my way.	( )	( )	( )		( )

This section of the survey asks for your opinion about the importance and desirability of relationships between people of different background, how often you participated in group situations working out conflicts and sharing ideas, and the techniques you use to encouraging participation when in group situations.
 

Cultural Competency

11. How much do you agree or disagree that each of the following statements describes you:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I can verbally communicate my ideas to other people	( )	( )	( )		( )
b. I listen to other people’s opinions or position on an issue	( )	( )	( )		( )
c. I collaborate on projects as a team member to achieve a shared goal	( )	( )	( )		( )
d. I get along with other people in my work environment	( )	( )	( )		( )
e. I resolve conflicts through discussion and dialog	( )	( )	( )		( )
f. I treat other people with courtesy and respect	( )	( )	( )		( )

12.  How often do you do the following:*

	Never	Rarely	Sometimes	Often	Very Often
a. I try to understand other people’s ideas and opinions before arguing or stating my own.	( )	( )	( )	( )	( )
b. I try to present my ideas without criticizing the ideas of others.	( )	( )	( )	( )	( )
c. I encourage different points of view without worrying about agreement.	( )	( )	( )	( )	( )
d. I try to consider all points of view or possible options before forming an opinion or making a decision.	( )	( )	( )	( )	( )
e. I encourage the participation of other people and support their right to be heard.	( )	( )	( )	( )	( )
f. I help find solutions when unexpected problems arise.	( )	( )	( )	( )	( )

13. How much do you agree with the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. If people from different backgrounds took the time to understand each other, there wouldn’t be so many social problems.	( )	( )	( )		( )
b. I feel comfortable belonging to groups where people are different from me.	( )	( )	( )		( )
c. Diverse viewpoints bring creativity and energy to a work group.	( )	( )	( )		( )
d. Multicultural teams can be stimulating and fun.	( )	( )	( )		( )
e. People are more motivated and productive when they feel they are accepted for who they are here.	( )	( )	( )		( )
f. Diversity brings many perspectives to problem-solving.	( )	( )	( )		( )
g. I feel comfortable in forming friendships with people who are different from me.	( )	( )	( )		( )

This section of the survey asks about your opinions on contributing to public life and participating in solving public problems, and volunteer experience prior to NCCC.

Participation in Solving Public Problems

14. How much do you agree or disagree with the following:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I feel a personal obligation to contribute in some way to my community.	( )	( )	( )		( )
b. I am actively involved in issues that positively affect my community.	( )	( )	( )		( )
c. I can make a difference in my community or neighborhood.	( )	( )	( )		( )
d. I feel I have the ability to make a difference in my community.	( )	( )	( )		( )
e. I try to find the time or a way to make a positive difference in my community.	( )	( )	( )		( )

15. If you found out about a problem in your community that you wanted to do something about, how well do you think you would be able to do each of the following:*

	I definitely could NOT do this	I probably could NOT do this	I'm not sure if I could do this	I probably could do this	I definitely could do this
a. Create a plan to address the problem	( )	( )	( )	( )	( )
b. Get other people to care about the problem	( )	( )	( )	( )	( )
c. Organize and run a meeting	( )	( )	( )	( )	( )
d. Express your views in front of a group of people	( )	( )	( )	( )	( )
e. Identify individuals or groups who could help you with the problem	( )	( )	( )	( )	( )
f. Express your views on the Internet or through social media	( )	( )	( )	( )	( )
g. Call someone on the phone you had never met before to get their help with the problem	( )	( )	( )	( )	( )
h. Contact an elected official about the problem	( )	( )	( )	( )	( )

Participation in Public Life

16. In the state where you live, are you eligible to vote?*

( ) Yes GO TO Q17

( ) No, not eligible to vote GO TO Q18

( ) Don’t know GO TO Q18

17. How often do you vote in local elections?*

( ) I do not vote in local elections

( ) Sometimes/occasionally

( ) When I can

( ) Every election

18. How likely are you to vote in future [general]/national elections?*

( ) Definitely will vote

( ) Probably will vote

( ) Probably will not vote

( ) Definitely will not vote

Education

19. Please select the highest level of education that you have completed:*

( ) a. Middle school GO TO Q20

( ) b. Some high school, I do not have a diploma or certificate GO TO Q20

( ) c. High school diploma or GED

( ) d. Technical school / Apprenticeship certificate or degree

( ) e. Some college

END

( ) f. Associate’s degree

( ) g. Bachelor’s degree

( ) h. Graduate degree

( ) i. Other, please specify:

Other, please specify:*

_________________________________________________

20. Do you plan to get a high school diploma or GED?*

( ) Yes

( ) No

( ) Not sure

Thank you again for taking the time to participate in this study.

Just to make sure that you receive the $20, could you provide your contact information?

First Name: _________________________________________________

Last Name: _________________________________________________

Street Address: ___________________________________________________

__________________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: _______________________________________________________

E-mail: _______________________________________________________

NCCC Leadership Development Corps Member Early Exit Short Questionnaire

OMB Control Number: XXX (Expires XX/XX/XX)

Reasons for Ending Service Early

There are many reasons why Corps members end their service early. NCCC is interested in understanding your NCCC experience and the reasons you might wish to end your service before graduation.

1. For each of the reasons below please indicate whether it contributed to your decision to leave early?*

	Yes	No
a. I was dismissed by the program	( )	( )
b. I want to go back to school	( )	( )
c. I found a job / I will start working	( )	( )
d. I am not earning enough money / I need to earn more money to help my family pay the bills	( )	( )
e. I have a condition that substantially limits my ability to do some physical activities	( )	( )
f. I have a mental or emotional condition that limits my ability to do some activities	( )	( )
g. I need to care for a family member or close friend	( )	( )
h. I felt disrespected by the people in the program
i. I do not feel valued by people in the program
j. People in the program did not try to get to know me
k. I do not get along with my supervisor or leadership (team leader, unit leader, or site supervisor)	( )	( )
l. I do not get along with the other members on my team	( )	( )
m. I am not making friends with the other people on my team	( )	( )
n. I am not learning the skills I need for the career I want	( )	( )
o. I do not feel part of the team	( )	( )
p. I am not gaining any leadership skills	( )	( )
q. I am not making a difference in people’s live with the projects I was assigned	( )	( )
r. I am not getting to do the type of work I thought I would be doing	( )	( )
s. My parents/guardians have told me I can come home	( )	( )
t. The work I was assigned is not fulfilling	( )	( )
u. I do not like the type of housing	( )	( )
v. I am joining the military	( )	( )
w. I am going to serve with Peace Corps	( )	( )
x. I am going to serve with another AmeriCorps program (ASN, VISTA)	( )	( )
y. NCCC has too much structure / too strict	( )	( )
z. I do not have internet access to do my assignments
aa. I could not complete my assignments because I am homeless, live in a motel or hotel room / live in boarding house, halfway house, or board and care facility
ab. Other reason for leaving, please explain	( )	( )

1z. Please explain reason for leaving:* (please provide any additional explanation you would like to share about your decision to leave early; if your decision to leave early is tied to the coronavirus pandemic you can explain it here)

____________________________________________

____________________________________________

____________________________________________

____________________________________________

2. Thinking about your NCCC service projects, please indicate how much you agree or disagree with each of the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I developed an understanding of the strengths of communities.	( )	( )		( )	( )
b. I can recognize solutions to challenges communities face..	( )	( )		( )	( )
c. I spent a lot of time doing meaningless “make work” tasks.	( )	( )		( )	( )
d. I felt defeated by the complexities of the problems that I worked on.	( )	( )		( )	( )

2b. Is there another statement you would like to add about your NCCC service projects?

1. Yes (Please write in the statement) [GO TO Q2c]

2. NO

2c. How do you feel about your statement? [response options: strongly agree, agree, neither agree or disagree, disagree, strong disagree]

3. Thinking about the people you interacted with in your NCCC team and in the communities you served, please indicate how much you agree or disagree with each of the following statements:*

	Strongly disagree	Disagree	Neither agree or disagree	Agree	Strongly agree
a. I was exposed to new ideas and ways of seeing the world.	( )	( )		( )	( )
b. I had an opportunity to interact with people who were different than me.	( )	( )		( )	( )
c. I re-examined my beliefs and attitudes about other people.	( )	( )		( )	( )
d. I re-examined my beliefs and attitudes about challenges communities face
e. I did not get along well with my supervisor or leadership (team leader, , unit leader, or site supervisor)	( )	( )		( )	( )
f. I did not feel value by the people in my team or group.	( )	( )		( )	( )
g. I felt that the people I worked with or lived with did not understand me.	( )	( )		( )	( )
h. I felt a sense of belonging on my team.	( )	( )		( )	( )
i. I felt accepted by my teammates.	( )	( )		( )	( )
j. I felt personally accepted in the communities in which I worked and served.	( )	( )		( )	( )
k. I get asked to contribute in planning social activities not directly related to my volunteer work
l. I am told about informal social activities and events
m. I am rarely invited to join other team members when they go out or to take a break

4. How often has your NCCC team done the following:*

	Never	Rarely	Sometimes	Often	Very often
a. We discuss issues and problems and share ideas.	( )	( )	( )	( )	( )
b. We involve everyone and avoid favoritism.	( )	( )	( )	( )	( )
c. We can disagree and be different from one another.	( )	( )	( )	( )	( )
d. We take time to work out any conflicts.	( )	( )	( )	( )	( )

5a. Is there anything that you would like to share about your NCCC team?

1. Yes (write in your statement) [GO TO Q5b]

2. No

5b. For the statement you shared about your NCCC team, how often has the team done this? [response options: never, rarely, sometimes, often, very often]

Contact information for the follow-up surveys

Thank you again for taking the time to participate in this survey.

Just to make sure we are able to contact you for the follow-survey, could you provide your contact information. We will protect all the information from the surveys and phone interviews. Your information will be stored in a safe and secure manner and (b) only used for research and/or statistical purposes. It will only be shared with CNCS staff and external parties who require the PII to complete their work. You will only be contacted for the purpose of this study. Your participation is voluntary, you can end your participation at any time.

First Name: ________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: ____________________________________

E-mail: ___________________________________

5. How would you prefer we contact you in the future?

1. Phone ____

2. Email ____

3. Mail ____

6. What is the best phone number, email address, or physical address where you can be reached?

________________________________________

Contact Information for Relative and Friend:

In order for the research team to reach you for the next survey, please answer the next two questions about how to find you.]

7. Is there a relative or friend, who does not live in this household, who will always know how to get in touch with you? The research team will only contact this person if it cannot locate you for the next survey.

NO.............................................................. 0 (END THE SURVEY)

YES............................................................. 1 (GO TO 8)

DON’T KNOW ............................................. 8 (END THE SURVEY)

Prefer not to answer ................................................... 9 (END THE SURVEY)

8. What is the name, address, and telephone number of that person?

First Name: ________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: (_____)__________________

Email: _________________________

9. What is this person’s relationship to you?

RELATIVE _________________ 2

NEIGHBOR ________________ 3

FRIEND ___________________ 4

OTHER (SPECIFY)___________________ 7

PREFER NOT TO ANSWER ................................................... 9

10. Is there another relative or friend, who does not live in this household, who will always know how to get in touch with you? The research team will only contact this person if it cannot locate you for the next interview.

NO.............................................................. 0 (END SURVEY)

YES............................................................. 1 (GO TO 11)

DON’T KNOW ............................................. 8 (END SURVEY)

REFUSED ................................................... 9 (END SURVEY)

11. What is the name, address, and telephone number of that person?

First Name: ______________________ Last Name: ____________________

Street Address: ____________________________________________________

____________________________________________________

City: ____________________ State: ___________ Zip: ____________

Phone: (_____) ________________________

12. What is this person’s relationship to you?

RELATIVE (SPECIFY)_________________ 2

NEIGHBOR (SPECIFY)________________ 3

FRIEND (SPECIFY)___________________ 4

OTHER (SPECIFY)___________________ 7

PREFER NOT TO ANSWER ................................................... 9

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