Name*

First Last

Grade level*

Preschool/Head Start
Elementary
Middle School
High School

School Name*

Address

Street Address City State Zip Code

Unified Sports

Please enter the total number of unique/individual athletes or Unified partners so far in the school year.

Unified athletes

Please enter a number greater than or equal to 0.

Unified partners

Please enter a number greater than or equal to 0.

Pre-k to 2nd grade

Young Athletes athletes

Please enter a number greater than or equal to 0.

Young Athletes partners

Please enter a number greater than or equal to 0.

3rd to 12th grade

During the FALL season (Aug-Dec), did your program implement any of the following UNIFIED Sports?

Check all that apply:

Select All
Badminton (AIA)
Bocce
Bowling
Soccer
Swimming
Golf

Number of Badminton Unified Sports athletes*

Please enter a number greater than or equal to 0.

Number of Badminton Unified Sports partners*

Please enter a number greater than or equal to 0.

Number of Bocce Unified Sports athletes*

Please enter a number greater than or equal to 0.

Number of Bocce Unified Sports partners*

Please enter a number greater than or equal to 0.

Number of Bowling Unified Sports athletes*

Please enter a number greater than or equal to 0.

Number of Bowling Unified Sports partners*

Please enter a number greater than or equal to 0.

Number of Soccer Unified Sports athletes*

Please enter a number greater than or equal to 0.

Number of Soccer Unified Sports partners*

Please enter a number greater than or equal to 0.

Number of Swimming Unified Sports athletes*

Please enter a number greater than or equal to 0.

Number of Swimming Unified Sports partners*

Please enter a number greater than or equal to 0.

Number of Golf Unified Sports athletes*

Please enter a number greater than or equal to 0.

Number of Golf Unified Sports partners*

Please enter a number greater than or equal to 0.

Unified PE athletes

Please enter a number greater than or equal to 0.

Unified PE partners

Please enter a number greater than or equal to 0.

Approximately how many days have you held the class so far?

January through June of current year?

number of class days*

Please enter a number greater than or equal to 0.

What is the general rate per hour (in dollars) that your school charges outside organizations for the space your class met in?

We use this number to estimate the value of donated goods and services for tax purposes.

Please enter a number greater than or equal to 0.

How much time do you spend in Unified PE class per session or period that you meet?

Inclusive Youth Leadership

A Unified Club (Best Buddies, Youth Activation Committee, etc.) is a club for students with and without intellectual disabilities that comes together for sports, games, community service, school events, and most of all, to have fun!

Unified Club athletes

Please enter a number greater than or equal to 0.

Unified Club partners

Please enter a number greater than or equal to 0.

Approximately how many times did your club meet so far this school year?

January through June of current year

Number of meetings*

Please enter a number greater than or equal to 0.

What is the general rental rate per hour (in dollars) that your school charges outside organizations for the space your club met in?

We use this number to estimate the value of donated goods and services for tax purposes

General rate per hour: Inclusive Youth*

Please enter a number greater than or equal to 0.

How much time do you spend in your club per session or period that you meet?

Whole School Engagement

During the FALL SEASON (Aug-Dec), did your program implement any of the following Unified Activities?

Check all that apply:

Select All
Fan in the Stands (ex. Students cheering on Unified Sports)
Pep Assembly (ex. Assembly specifically for Unified OR recognized during regularly scheduled school assembly)
Unified Sports Day (ex. Field day, sports expo, Unified Fan Activation)
Health LEAP
Unified Activities (SOAZconnected virtual activity/engagement opportunity, music, ukulele, robotics, Esports, choir, band, dance, etc.)

Unified Activities athletes*

Please enter a number greater than or equal to 0.

Unified Activities partners*

Please enter a number greater than or equal to 0.

Type of Inclusive event(s) your program plans to implement as part of your Spread the Word: Inclusion campaign and/or Disability Awareness Week:*

Check all that apply:

Select All
Spread the Word: Inclusion Campaign
Minute that Matters
Unified Activities Challenge
Spirit Week
Pep Rally
Other

Other Specify*

SOAZ would love to help support your Spread the Word: Inclusion Campaign event. Please share any specific information you have so we can come join you on campus for the event!

Date of event

Time of event

:

Exact location (e.g., school courtyard or football field):

What else should we know about your event(s)?

If you are holding multiple events (ex. Minute that Matters, Pep Assembly, Disability Awareness Week, etc.) please share the date(s), time(s), and location(s) of each event below:

Thank you for filling out the Unified Champion Schools Midterm report!

Keep an eye out for YOUR Spread the Word: Inclusion kit as a thank you for helping the Unified Champion Schools track how Inclusion is reaching our athletes and Unified partners.

If you would like more information on how to implement the Spread the Word: Inclusion Campaign or Disability Awareness week, please reach out to the Unified Champion Schools contacts!

THE REVOLUTION IS INCLUSION

#stayconnected #stayunified

Midterm Survey

Midterm Survey

Unified Sports

Inclusive Youth Leadership

Whole School Engagement

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