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Hi, we would like to know what you are concerned about and how you feel about your life. This is not a test and there are no right or wrong answers. The information from all young people who fill in this form will help Save the Children to improve our programs.
 
 
 
My name is:
   
 
 
 
Have MY Van activities helped you at school?
 
Yes
 
No
 
 
 
How have they helped?
   
 
 
Health
Strongly agree Mostly agree Mostly disagree Strongly disagree
My health is good
I eat breakfast every day
I do some sports every week
Most of my friends smoke cigarettes regularly
Many of my friends are using alcohol or other drugs regularly
 
 
 
Have you learned how to be healthier at MY Van?
 
Yes
 
No
 
 
 
What have you learned?
   
 
 
Social Support
Strongly agree Mostly agree Mostly disagree Strongly disagree
Other students at my school are friendly
I have friends who give me support an encouragement
I get along well with my family
When I have problems I have someone to talk to
I feel well connected with my community and culture
 
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