BVCS After-School Program
BVCS is considering running an after-school program. To aid in that decision, this questionnaire will give us important information about the interest and need for such a program.

All responses will be confidential. Answering this survey does not commit you to attend or participate.

About You
It is helpful for us to know a little about you.
Your gender *
Your relationship to BVCS *
About Your Family
Please tell us a bit about your family.
How many children in your family? *
0 children
1 child
2 children
3 children
Aged 0 - 4
Aged 5 - 8
Aged 9 - 12
If you are a single-parent family, just use the 'parent 1' line. If you have two parents in the home, use both lines.
Not employed
Employed part time
Employed full-time
Parent 1
Parent 2 (if applicable)
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