What school does your child attend? *

What is the gender of your student(s)? *

In the past year, how often have you visited your child's school? *

To what extent do you think that children enjoy going to your child's school? *

Check the area that the CIS Site Coordinator can help your student. *

Please list the three most pressing needs for your student(s).

When would you be most available to attend school events for your student(s)? *

Please select the programs that your student(s) participated in last school year. *

What events did you participate in this past year? *

What types of events would you like to see?

Would you be willing to volunteer? *

Did your student(s) receive clothing or school supplies from Communities In Schools last year? *

Are there any clothing or school supplies needs you had last year that were not met? Please describe.

On a scale from 1 (very low) to 7 (very high), please rate how well the community, local organizations and volunteers support the needs of your student(s)? *

Do you have any other comments, questions, or concerns?

If you would like to be contacted please leave your name, phone number and email.