School Extracurricular Interest Poll Form

School Extracurricular Interest Poll Form
Let us know your interests in school clubs and activities to help us plan better programs.
Student Full Name
First NameLast Name
Grade/Year Level
Homeroom Teacher
Student Email Address (if available)
example@example.com
Parent/Guardian Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Which extracurricular activities are you interested in? (Select all that apply)
Other

How interested are you in the following types of extracurricular activities?

Rows	Not Interested	Somewhat Interested	Very Interested
Sports
Arts (e.g., painting, drawing)
Performing Arts (e.g., music, drama)
STEM (Science, Technology, Engineering, Math)
Leadership (e.g., student council)
Community Service

Do you have previous experience in any extracurricular activities?
If yes, please describe your previous extracurricular experience.
When are you generally available for extracurricular activities? (Select all that apply)
Other
Would you like to suggest any new clubs or activities?
Please share any additional comments or ideas regarding extracurricular programs.
Should be Empty:

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