Youve Pledged, Youve TrainedHow Can Power Up for 30 Support

You?
1) Name: ______________________________________________________________
2) Email: ______________________________________________________________
3) School Name: ________________________________________________________
4) Primary Position at School: ____________________________________________________
5) Which of the Power Up for 30 Plan(s) is/are you implementing at your school? (Check all that
apply)
__Before school physical activity program
__Physical activity in the classroom
__Recess
__After school physical activity program
__School-wide (all students are participating at the same time- i.e. during morning
announcements)
__None of the above
6) What facilitators have aided you when implementing Power Up for 30? (Check all that apply)
__Administrative support
__Grant money
__Time
__None of the above
__Other (please specify) __________________________________________________________________
7) Please give a detailed description of successes your school has experienced as a result of Power Up
for 30?

8) What support from your schools administration has been most helpful in implementing Power Up
for 30?

9) What barriers/struggles have hindered you from implementing Power Up for 30?
__Time
__Staffing (i.e. numbers or enthusiasm of staff)
__Equipment
__Space
__Transportation
__Weather
__None
__Other (please specify) ________________________________________________________________

10) Please indicate your preference for connecting with the other trained Power Up for 30 schools
across the state?
(Check all that apply)
__
__
__
__
__
__
__
__

PLU virtual booster session

Existing summits/conferences (i.e. GAEL, GAHPERD, Share the Wealth, etc.)
Web-based forum/blog
Webinars
Teleconference
TwitterChat
None of the above
Other____________________________

11) What type of additional follow up assistance, if any, would be beneficial now? (Check all that
apply)
___
___
___
___
___
___
___

Email correspondence with HealthMPowers, SHAPE staff, and other schools

Blog/portal for teachers to post physical activity resource that have worked for them
Onsite visits of programs and implementation
Phone assistance/Conference calls
Web-based Q&A forum
TwitterChat with staff and other schools
Other (please specify)_________________________________________________________________

12) Please indicate the types of recognition you would be interested in receiving for your efforts?
(Check all that apply)
__ On-site visit from state leaders
__ Website article or featured story of your Power Up for 30 success
__ Website
__ Resources from Power Up for 30 Champion Resources
__Power Up for 30 branded merchandise
__ Website portal for posting successes and sharing ideas with other trained schools
__ Other (please specify) _________________________________________
13) Did you receive last months newsletter? (Circle one)
a. Yes
b. No
14) If you received last months newsletter, did you read it? (Circle one)
a. Yes clicked on links and read each story
b. Yes but just scanned the content
c. No didnt open it
15) If you received last months newsletter, it was (Circle one)
a. Too long
b. Too short
c. Perfect amount of content
16) If additional funding were secured for additional training, how likely are you to attend? (Circle one)
a.
b.
c.
d.

Very likely
Likely
Maybe
Unlikely

17) What was your favorite section of the newsletter and why? (i.e. featured story, school success story,
Resource Guide spotlight, Resource Guide link and password, announcements, or news you can use)

18) Any other comments/input you would like to make about future support for Power Up for 30?