Unified Champion Schools Mid-Year Survey 22-23

Mid Year Update - Please Complete

Thank you in advance for completing this important survey! Please let us know what you have done the first half of the year in the areas of Unified Sports, Inclusive Leadership and Whole School Engagement. Reminder - at least one activity must be completed in each area by the end of the school year, to be considered a Unified Champion School for 2022-23. If you are responsible for more than one school, please complete a separate form for each Unified Champion School.

School Name:*

Primary Contact (Liaison):*

Email Address:*

Unified Sports

Please let us know what Unified Sports has looked like at your school the first half of the year. Please check all activities 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. Traditional Athletes are students with intellectual disabilities and Unified Partners are students without intellectual disabilities.

Young Athlete Program (PRE-K, ELEMENTARY)

Number of Athletes*

Number of Unified Partners*

How often do your students participate in Young Athlete activities?*

Unified Basketball (MIDDLE, HIGH SCHOOL)

Number of Athletes*

Number of Unified Partners*

How often do your students participate in practice?*

Unified Bocce (HIGH SCHOOL)

Number of Athletes*

Number of Unified Partners*

How often do your students participate in practice?*

Unified Physical Education (ELEMENTARY, MIDDLE, HIGH SCHOOL)

Number of Athletes*

Number of Unified Partners*

How often do your students participate in practice?*

Unified Fitness (ELEMENTARY, MIDDLE, HIGH SCHOOL)

Please share all Unified Fitness platforms that you utilized (Examples include: Fit 5 Curriculum, Hip Hop Pubic Health Lessons, School of Strength, Live Fitness classes)

Number of Athletes*

Number of Unified Partners*

How often do your students participate in practice?

Unified Strength & Conditioning (HIGH SCHOOL)

Number of Athletes*

Number of Unified Partners*

Other Examples of Unified Sports (Please Explain)

Number of Athletes*

Number of Unified Partners*

Inclusive Youth Leadership

Please let us know what Inclusive Youth Leadership has looked like at your school the first half of the year. Please check all activities 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. Traditional Athletes are students with intellectual disabilities and Unified Partners are students without intellectual disabilities.

Unified Advisor Name

Unified Advisor Email

Student President/Leader Name

Student President/Leader Email

Inclusive Student Council

Number of Athletes*

Number of Unified Partners*

Best Buddies Club

Number of Athletes*

Number of Unified Partners*

Unified Club

What is the name of your club?*

Number of Athletes*

Number of Unified Partners*

Unified Young Reader's Club

Number of Athletes*

Number of Unified Partners*

Young Athletes Student Coaches

Number of Athletes*

Number of Unified Partners*

Other Examples of Inclusive Youth Leadership (Please Explain)

Number of Athletes*

Number of Unified Partners*

Whole School Engagement

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

Polar Plunge or Other Fundraiser