Community 101 - Community Action Survey

Our Community 101 student organization is trying to help improve our community through volunteerism
and philanthropy. We need your help so that our time and money will have the biggest impact. Our
Community 101 organization has up to $5,000 to give to programs that inspire, change, and encourage potential in
one of four areas: education, the promotion of healthy families, access to the arts, or environmental
enhancement. We’d like your input in determining a focus for this funding.

Name (optional): 


A red asterisk (*) indicates required questions.


  1. What issues facing you and our Crater community (school, neighborhood, family, friends) do you think have the greatest need for support? Rank each of the issues with “5” being of greatest concern to you and “1” being of least concern.*

          1 2 3 4 5    
      Alcohol Abuse   
      Drug Abuse   
      Teen Pregnancy   
      Stress   
      Lack of Self Esteem   
      Racism   
      Suicide   
      Runaways   
      "Kicked Out" Youth   
      Children living in poverty   
      Lack of recreational facilities/programs   
      Problems of people with disabilities   
      Child abuse   
      Rape/Date Rape   
      Abuse of elderly   
      Violence in schools   
      Aids   
      Lack of arts and music   
      Divorce problems   
      Problems with parents   
      Problems with education   
      Personal finance education   
      Discrimination   
      Hunger   
      Depression   
      Illiteracy   
      Inadequate housing   
      Single parent homes   
      Lack of awareness of available Social Services   
      Homelessness   
      Prostitution   
      Vandalism and graffiti   
      Access to guns   
      Poor health care   
      Juvenile crime   
      Decreasing voter turnout   


  1. If you think none of these are the number one problem, please tell us what you think it should be.


  1. Any other comments?


  1. Would you be interested in joining our student organization, Community 101? We will be starting meetings within the next few weeks in order to write our mission statement and determine non-profit organizations in the Rogue Valley that meet our mission. If so, please leave your full name - this information will not be shared).