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    This document contains a 14-question voluntary questionnaire for high school students to gauge their interest in participating in an LGBTQ college mentorship program. The questions ask about students' age, year in school, gender identity, sexual/gender labels they use, whether they are "out", challenges they face in high school due to their identity, interest in an LGBTQ mentor, concerns about the program, preferred meeting frequency, potential future interest in being a mentor, and suggestions for the program. The goal is to design a mentorship program between college and high school students who identify as LGBTQ.

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    This document contains a 14-question voluntary questionnaire for high school students to gauge their interest in participating in an LGBTQ college mentorship program. The questions ask about students' age, year in school, gender identity, sexual/gender labels they use, whether they are "out", challenges they face in high school due to their identity, interest in an LGBTQ mentor, concerns about the program, preferred meeting frequency, potential future interest in being a mentor, and suggestions for the program. The goal is to design a mentorship program between college and high school students who identify as LGBTQ.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    101 views3 pages

    Sample Questionnaire

    Uploaded by

    api-278602608
    This document contains a 14-question voluntary questionnaire for high school students to gauge their interest in participating in an LGBTQ college mentorship program. The questions ask about students' age, year in school, gender identity, sexual/gender labels they use, whether they are "out", challenges they face in high school due to their identity, interest in an LGBTQ mentor, concerns about the program, preferred meeting frequency, potential future interest in being a mentor, and suggestions for the program. The goal is to design a mentorship program between college and high school students who identify as LGBTQ.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 3

    Student Questionnaire LGBTQ College Mentorship Program

    Your participation in this quick questionnaire is completely voluntary, so you dont


    need to answer any of these questions if you dont want to. Additionally, if any
    questions make you feel uncomfortable, its completely okay for you to leave them
    blank!
    1. How old are you? ________
    2. Whats your school year? (please circle one)
    Freshman

    Sophomore

    Junior

    3. What is your gender identity?

    Senior
    ___________________________

    4. If you identify as LGBTQIAP+ and use a label for your sexual/gender identity,
    which label(s) do you usually use? (circle as many as you want, and/or fill in the
    blank on the bottom right)
    Lesbian

    Queer

    Demisexual

    Gay

    Intersex

    No label/I dont know

    Bisexual

    Asexual

    Trans

    Pansexual

    Other:
    _____________________

    5. Are you comfortable with other people knowing your gender/sexual identity? In
    other words, would you consider yourself to be out?
    Yes
    to answer

    No

    Kinda? (i.e. certain people)

    I dont know/Dont want

    6. From your personal experience, is there anything that makes high school harder
    for you because you identify as LGBTQ+? If so, what are some of those things?

    7. If you had a mentor who was a college student and also identified as LGBTQ+,
    do you think it would make your high school experience better or easier in any way?
    How or why?

    8. Would you be interested in participating in a mentorship program with college


    students?
    Yes

    No

    I dont know

    9. If you answered no or I dont know on question 8, what are some of your


    concerns about the program? (if you answered yes on question 8 you can answer
    this question too, if you are interested in the idea but have some concerns)

    10. If you are interested in the program, how often would you like to meet with your
    mentors? (assume that transportation is not an issue we can work that out later!)
    Once a week
    months

    Twice a month
    Im not interested

    Once a month

    Every few

    13. If you are planning to go to college, would you be interested in someday


    becoming a college mentor for a high school student who also identifies as
    LGBTQ+?
    Yes

    No

    Maybe

    I dont know

    14. Do you have any final suggestions for how to run the mentorship program with
    college students or anything else youd like us to know?

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