Youth Questionnaire 

Please fill in this form to help us gather information about our young people, also available in PDF format for download.

Please note that all data is collected anonymously and there is no direct link to your identity or location. Please tick that applies to you

1. From the following tell us what is your age group: 8-10 11-14 15-18 19-23 24+

2.Gender: Male Female

3.Ethnic Background:
Asian or British Asian (Bangladeshi) Asian or British Asian (Indian) Asian or British Asian (Pakistani) British Irish Black or Black British(Caribbean) Black or Black British(African) Other
Your faith group and area you live in: Sandwell Walsall Birmingham Wolverhampton Other Muslim Hindu Christian Sikh Other

4.If you are studying full time, do you go to a; State School College Full time Islamic School University Other

5. Do you have any learning difficulties at school? Yes No

6. Would you like to have additional classes to help you in your studies? Yes No

7.Do you attend in the evening; Mosque/Madrassa Evening School Sport/Social Club

8. Do you have any local sport or social activities that you can go to? Yes No

9. Have you experienced any
(a) racism, Yes No
(b) Islamophobia, Yes No (c)extremism, Yes No

10. In questions 9 a, b and c above, can you describe why you think this has happened?

Thank you very much for taking part in this questionnaire