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Parent Welcome Survey
Please fill out each question to the best of your ability.
Student Demographics
Student Name *
First and Last
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Does your child wear glasses? *
Student Transportation *
Please let us know your child's method of afternoon transportation.
Bus
Car Rider
AYS
Boys and Girls Club
Mon.
Tues.
Wed.
Thurs.
Fri.
Bus Number *
If your child does not ride a bus please put N/A
Your answer
Does your student have family members that attend PRE?
List their name and grade.
Your answer
Special Concerns
Please let us know if you have any concerns about your child academically, behaviorally, etc.
Your answer
Known Allergies *
If no allergies please put none.
Your answer
Please list 2 goals you have for your child this year.
They can be academic, behavioral, etc.
Your answer
Is there anything else I need to know about your child?
Your answer
Parent Demographics
Parent 1 *
Your answer
Parent 1 Email *
Your answer
Home Phone Number *
Your answer
Cell Phone Number
Your answer
Work Phone Number
Your answer
Which number would you choose as a preferred contact? *
Parent 2
Your answer
Parent 2 Email
Your answer
Home Phone Number
Your answer
Cell Phone Number
Your answer
Work Phone Number
Your answer
Which number would you choose as a preferred contact?
Volunteer Information
If you can volunteer please select the day/time and what you can help with.
Making Copies
Laminating and Cutting
Working with Students
Mon AM
Mon PM
Tues AM
Tues PM
Wed AM
Wed PM
Thurs AM
Thurs PM
Fri AM
Fri PM
Do you have internet at home? *
What type of technology does your child have access to?
Choose all devices that are available and whether they can get online.
EMERGENCY INFORMATION
Contact Person 1 *
If you are unreachable who can we call in case of emergency?
Your answer
Relationship to Student *
Your answer
Phone Number 1 *
Your answer
Phone Number 2
Your answer
Contact Person 2
If you and your first contact are unavailable who else can we call?
Your answer
Relationship to Student
Your answer
Phone Number 1
Your answer
Phone Number 2
Your answer
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