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					                                Hindu Society of North Carolina Greensboro Chapter
                           Teen Community Outreach Committee Survey – October 2009
The hope of the Teen Community Outreach committee is to develop a temple based program (from 2010) that
provides opportunities for our middle school and high school students to: participate in community service
activities; develop leadership/planning skills; foster fellowship between Indian youth; strengthen the youth
commitment to the temple, and most importantly have fun. The following survey items will help the planning
group develop the temple’s teen program. This form is to be completed by the teen and their parent(s). First
we will see if there is any interest among the teens and their families. The next step is to ascertain what
resources are available to do any type of program. The success and sustainability of this program cannot hinge
on the efforts of one person and will require participation of each family involved. Please write legibly.
         Teen’s Name             Gender Name of School and Current outreach/service activities involved in
                                  M/F             Grade in                               (if any)




           Mother’s Name                     Father’s Name                 Email            Phone (Home or Cell)

Is your family currently an HSNC Member: Yes ____ No ___
1. Identify issues where Indian teens can make an impact in the Greater Greensboro area or internationally?
     (hunger, literacy, homelessness, disability, etc.)



2. Identify community organizations where you (your teen) would be willing to volunteer.



3. What days are you most willing to meet and how often (once a week, twice a month, monthly)?



4. If you are an adult, would you be willing to mentor or supervise teen activities?



5. Please circle activities or add ones that you (your teen) would like to see as part of our schedule of events.
Temple Service        Community             Fundraising           Fellowship/Fun        Other
                      Outreach
Puja set up/clean     Urban Ministry        Food/toiletry drive   Movie Night           College or High
up                                          for shelters                                School Night
Gardening/planting Greensboro Public        Temple Youth          Sking                 Indian Youth Forum
                      Library               fundraisers           Camping
Organizing summer Children’s                JDRF Walk             Ping Pong/ Chess      Temple Teen
temple camp           Museum                                      Tournament            Website/Newsletter
Organizing special    Interfaith Youth      Great American        Bhangra/Dandia        Trips to ashram
children’s activities collaboration         Bake Sale             Dance Party           summer camps
Organizing Youth      Volunteer at          Parent Youth          Carowinds or          India Trip
Puja                  Nursing Home          Cricket Match         Beach Trip            Collaboration
                      Science Center                              Yoga

				
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