Survey - Million Hours of Power Survey 2010-2011 - National Center for Fathering -- fathers.com

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Million Hours of Power Survey 2010-2011

Questions marked * are required.

Email address (optional) to receive e-mail from National PTA:


	Email:

*2.

Question - Required - My volunteer service totaled ____ hours.

*3.

Question - Required - Describe your volunteer experience (i.e. assisted with distributing lunch, participated in classroom activity, coached basketball practice, etc.):

*4.

Question - Required - My experience as a volunteer was rewarding. Strongly Agree
Agree
Uncertain
Disagree
Strongly Disagree

*5.

Question - Required - My child(ren) was (were) proud of me for volunteering. Strongly Agree
Agree
Uncertain
Disagree
Strongly Disagree

*6.

Question - Required - After serving as a volunteer, I see how important it is for men to be involved with children on an regular basis. Strongly Agree
Agree
Uncertain
Disagree
Strongly Disagree

*7.

Question - Required - I will volunteer again. Strongly Agree
Agree
Uncertain
Disagree
Strongly Disagree

*8.

Question - Required - How did you hear about PTA's Million Hours of Power Campaign?

Question - Not Required - If you answered "other" in the previous question, please explain.

*10.

Question - Required - I was able to volunteer today by: Taking time off work WITH pay
Taking time off work WITHOUT pay
Using community service hours provided by my employer
Having a schedule or shift that allows flexibility
Volunteer service was not during my usual work hours
Currently unemployed
Currently retired

*11.

Question - Required - Please indicate the main mentoring role you play with the child(ren) in your life: Father
Step Father
Grandfather
Uncle
Brother
Male Volunteer
Other

*12.

Question - Required - My current age is: 18-20
21-29
30-39
40-49
50-64
65+

13.

Question - Not Required - My ethnicity (optional): African-American
American Indian
Asian
White/Caucasian
Latino/Hispanic
Other

*14.

Question - Required - Please describe the highlight of your volunteer experience:

15.

If you would like to be named on the Million Hours of Power Wall of Fame, please provide the information below:

Name:

First Required	Last Required

State / Province:

Date of Birth:

16.

You can continue to strengthen your relationship with your child by improving your fathering skills. Start today with a free subscription to the fathers.com weekly e-mail from the National Center for Fathering and a monthly parenting-focused e-newsletter from National PTA. Simply provide the requested information below: (PLEASE NOTE: your comments in the survey are CONFIDENTIAL and ANONYMOUS whether or not you request this subscription)

Name:

First Required	Last Required

Email:

State/ZIP:

State	ZIP

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