2019-2020 Needs Assessment Survey Form
Dear Parent/Guardian: We are in the process of conducting an evaluation to identify needs in the Asbury community. Please take a few moments and complete this survey. If you have any questions please email Tammy Pearce at
, Your responses will be used to help achieve funding to connect community and school by obtaining Early Drop Off/After School Tutoring/ Summer School. . We need this survey completed by no later than August 15, 2019 Thank you in advance for your support.
How many people are living in the home?
What is the highest level of education in the home?
GED High School Diploma
Do you have Internet access in your home?
Are you employed?
I work in Marshall County
I do NOT work in Marshall County
Do you, or additional family members, need help with the following skills?
Please check which program(s) below you feel would meet the needs of the Asbury community.
Extended Care Programs Healthy Lifestyles
Extended Morning (before school)
Extended Day (after school)
Extended Summer School
Would you be interested in attending any of the following classes?
English Language Acquisition
No I am not interested.
Please list any other classes you would be interested in.
Do you have any skills that you would be willing to volunteer your services for school related activities? If yes, What are they?
What extracurricular activities do you feel would benefit the needs of the Asbury community in addition to academic assistance and after school care? (Example: soccer, basketball, sewing, crafts)
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