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MCS COVID-19 Re-Entry Survey: PARENTS/CAREGIVERS
Complete one survey for each child. Only submit information for your child who is anticipated to be enrolled in the Manchester City School District in 2020-2021.
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* Indicates required question
Student Name (First Name) - Optional
Your answer
Student Name (Last Name) - Optional
Your answer
Parent Name (First, Last)-Optional
Your answer
Optional- How can we get in touch with you? ( Please list Phone, Address, Email)
Your answer
School
*
Choose
College Street Elementary
Westwood Elementary
Westwood Middle School
Grade Level for the 2020-2021 school year
*
Choose
PreK
Kindergarten
1
2
3
4
5
6
7
8
Given the current situation with COVID-19, Do you feel comfortable sending your child to school this Fall?
*
Yes
No
Unsure
If you answered "no" or "unsure", please describe your concerns.
Your answer
Are there devices in your home other than cell phones with which your child(ren) can access the internet for instructional purposes?
*
Yes
No
Rate the connectivity of your home WIFI.
*
We do not have WIFI
Very Unstable
Cell Phone Only
Somewhat unstable at times
STRONG, no connectivity issues
Other:
8. For which area(s) could you use additional support or information about resources at this time? Please select all that apply.
Food
Shelter
Childcare
Healthcare
Mental and Emotional Health
None
Other
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