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 pearce.tammy@marshallk12.org, 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? *
Your answer
What is the highest level of education in the home? *
Do you have Internet access in your home? *
Are you employed? *
Required
Do you, or additional family members, need help with the following skills? *
Required
Please check which program(s) below you feel would meet the needs of the Asbury community.
Extended Care Programs Healthy Lifestyles *
Required
Would you be interested in attending any of the following classes? *
Required
Please list any other classes you would be interested in.
Your answer
Do you have any skills that you would be willing to volunteer your services for school related activities? If yes, What are they?
Your answer
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)
Your answer
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