UCS End of Year Survey

End of Year Survey - Please Complete

Thank you in advance for completing this important survey! Please let us know what you have done throughout the school year in the areas of Unified Sports, Inclusive Leadership and Whole School Engagement. Reminder - at least one activity must be completed in each area, to be considered a Unified Champion School for the 2021-22 school year. We understand this has been another challenging year – if you only were able to complete 1 or 2 of the 3 components, that’s ok. If you have any questions, please reach out. If you are responsible for more than one school, please complete a separate form for each Unified Champion School.

School Name:*

Primary Contact for Unified Champion School (liaison):*

Email Address:*

Unified Sports

Please enter the total number of unique/individual Athletes and Unified Partners who have participated in one of the below Unified Sports options listed. Please check all that apply. Please place a zero in fields for which you have no numbers to report.

Young Athlete Program (PRE-K, ELEMENTARY)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

How many semesters (series of multiple weeks) have you introduced Young Athletes activities in the classroom this school year?*

1
2
3
Other

Has your school participated in a culminating Young Athletes celebration event?*

Yes
No

Unified Basketball (MIDDLE, HIGH SCHOOL)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Did you participate in any games? If so, how many?*

Unified Track & Field (HIGH SCHOOL)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Unified Bocce (ELEMENTARY, MIDDLE, HIGH SCHOOL)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Unified Physical Education (ELEMENTARY, MIDDLE, HIGH SCHOOL)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

How many semesters (series of multiple weeks) have you completed Unified Physical Education units this school year?*

1
2
3
Other

Unified Fitness (ELEMENTARY, MIDDLE, HIGH SCHOOL)

Fitness Challenges, Fit 5, School of Strength Videos, Hip Hop Public Health Videos, etc.

Please explain how you incorporated Unified Fitness in your school this year?

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Unified Strength & Conditioning (HIGH SCHOOL)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Unified Recess (PRE-K & ELEMENTARY)

Structured activity during recess time (bocce, kickball, walking group, etc.) where students with and without disabilities participated together for a series of weeks.

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Other Examples of Unified Sports (Please Explain)

Inclusive Youth Leadership

Please let us know what Inclusive Youth Leadership looked like at your school this year. Please check all that apply. Then complete all sections below and include number of traditional athletes and unified partners who participated. Please place a zero in categories for which you have no numbers to report as of now. If you are responsible for more than one school, please complete a separate form for each Unified Champion School.

Unified Club Advisor Name

Unified Club Advisor Email

Unified Team Captains (Athlete/Partner Pair)

Student Council

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Number of activities your students helped to plan:

Best Buddies or Unified Club

What is the name of your club?*

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Number of activities your students helped to plan:*

Unified Young Reader's Club

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Unified PE Student Coaches

Students with and without disabilities help to lead warm ups, cool downs, and set up stations stations during the class. Students can also help to model classroom rules and expectations.

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Other Examples of Inclusive Youth Leadership (Please Explain)

Number of Athletes (Students with an Intellectual Disability)*

Unified Partners (Students without an Intellectual Disability)*

Whole School Engagement

Please tell us what activities you have completed as it relates to including a larger portion of the student community. Please check all that apply. Then complete all sections below and include the number of students and staff that participated. If you are responsible for more than one school, please complete a separate form for each Unified Champion School.

Polar Plunge or Other Fundraiser

Number of Students and Staff Involved*

Kindness Day/Week

Number of Students and Staff Involved*

Inclusive Schools Week

Number of Students and Staff Involved*

Stride or Step Challenge as a School

Number of Students and Staff Involved*

Respect or Awareness Week (Or Similar)

Number of Students and Staff Involved*

Spread the Word Inclusion Campaign

Number of Students and Staff Involved*

Fans in the Stands

Number of Students and Staff Involved*

Social Emotional Health Lessons

Number of Students and Staff Involved*

Other Examples of Whole School Engagement (Please Explain)

Number of Students and Staff Involved*

Summary

Any additional notes or comments?

Thank You!

Any questions, please contact schools@specialolympicsma.org

End of Year Survey 2021-2022

End of Year Survey - Please Complete

Unified Sports

Inclusive Youth Leadership

Whole School Engagement

Summary

Thank You!