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21 Questions
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21 Street S.M.A.R.T. Questions
Answers are anonymous.
People
Your Age
Please select...
9-12
13-17
18-24
Gender
Please select...
Female
Male
Race
Please select...
African American
Asian
Hispanic
Latino
Pacific Islander
Other
Do you live with your parents?
Please select...
Yes, Both
Yes, One
No, Neither
Is one or both of your parents incarcerated?
Please select...
Yes
No
Who is your role model?
What are the ages of your children?
Places
If money is not an object, which would you prefer?
Please select...
College
Job Corp
Are you willing to relocate?
Please select...
Yes
No
Have you ever been incarcerated?
Please select...
Yes
No
If yes, what will stop you from ever being incarcerated again?
Do you feel safe where you live?
Please select...
Yes
No
Are you homeless?
Please select...
Yes
No
What causes the crime where you live?
Check all that apply.
Lack of Resources
Lack of Father in the House
Lack of Education
I Don't Know
Lack of Jobs
Lack of Recreation Facilities
Lack of After-School Programs
Lack of Role Models
How would you change your community in order for you to be a better person?
Things
Which of these job fields interest you the most?
Medical -
e.g., medical assistant, dental hygienist
Education -
e.g., teacher's aid, pre-school teacher
Construction -
e.g., sheriff, police officer, crime scene investigator
Law Enforcement -
e.g., sheriff, police officer, crime scene investigator
Media -
e.g., videographer, phone sales, news or radio announcer
Have there been any tragic events in your life such as molestation, or witnessing a rape or murder?
Please select...
Yes
No
Have you ever been shot at?
Please select...
Yes
No
Are your parents on drugs?
Please select...
Yes
No
Do you have medical insurance?
Please select...
Yes
No
Do you receive welfare?
Please select...
Yes
No
Who do you trust?
Did you know?