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Survey
Survey
Name:
Email:
Phone:
Message:
Age
Date of Birth
Grade entering Fall 2020
Registered School
Free Text
Hobbies
1. What interest you about our program?
2. What is a short term goal you plan to have achieved by the end of 2020?
3. What is a long term goal you plan to have achieved by the time you graduate high school?
4. What career aspirations do you have for after high school?
5. Do you plan to attend a vocational/trade school or 2/4 year college? Which school?
6. What is something you need to individually work on?
7. Tell me something important about you that you think we should know:
8. Are you an active participant in any community groups?
9. Do you think there is a need for MoXie Way, Inc in your area? Explain
10. Would you be interested in (select all that apply):
Individualized learning based on your interest
School Tracking Services
College Scholarships
Fall Camp
Tutoring Academic Challenges
Proctored Testing Site
Family Engagement Classes
Personalized Mentoring
Verified Volunteer Hours
Helping the community people
Parenting Classes
College Prep Courses
Growth within the company Networking with new Art/Music/Dance/Creative
Writing
Technology
Meditation/Guided
Work Out Sessions
Life Skill Training
Job Skill Training
Behavioral/Mental Health Support
Nutrition Education
MoXie Gear
Fundraising Events
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Home
About
Meet The Founders + Chief Executive Directors
Meet The Board Members
Community Engagement Initiative
Programs & Services
Double Dutch
Moxie Photo Gallery
Contact Us
Contact
(901) 584-7302
Mailing Address
PO BOX 771325
Memphis, TN 38177
themoxieway1@gmail.com
Contact Us
Moxie Way © - All rights reserved 2021
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