Primary Family Survey FY18
Please complete this form so that we may know what you think about the Title I School-wide Programs offered to your child. (If you have more than one child in the building, you only need to fill it out once)

Title I Programs:

READING RECOVERY (RR): Reading Recovery is a one-to-one intervention program for those 1st graders at-risk of not learning how to read.

LEVELED LITERACY INTERVENTION (LLI): Leveled Literacy Intervention (LLI) consists of a series of planned lessons designed to provide additional help to small groups of Kindergarten, First, Second, and Third grade children who are finding it difficult to learn to read and write.

Date
MM
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DD
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YYYY
School where my child attends
My child is in the following grade: (If you have more than one child in the building, choose all grades that apply)
My child had been involved in/with: (Choose all that apply)
My child has been involved in/with (Check all that apply)
Do you feel the services above helped your child?
In your opinion, where does your child need extra help? (Please choose one)
At which grade levels is it most important to provide extra help? Please number your first, second, third and fourth choice.
First Choice
Second Choice
Third Choice
Fourth Choice
PreK-3
Grades 4-6
Grades 7-8
Grades 9-12
In your child's building, which grade level is the most important to provide extra help? Please number your first, second, third, fourth, and fifth choice.
First Choice
Second Choice
Third Choice
Fourth Choice
Fifth Choice
PreK
Kindergarten
First Grade
Second Grade
Third Grade
When is the best time to offer extra help for your child?
Would you be able to provide transportation for your child before or after school?
How did you learn about services provided at your child's school?
Do you feel welcome in your child's school
During the school year, I was involved in:
Do these activities meet your needs?
Choose the following items that would help you attend school activities:
Other suggestions for the above question
Your answer
In your opinion, how might Title I funds be used for Parent & Family Involvement?
Would you be interested in becoming a member of your child's building Building Improvement Committee?
In your opinion, what are the strengths of your child's school?
Your answer
What would you improve?
Your answer
I am interested in volunteering in my child's school next year.
If you answered yes above, please provide your Name, Child's Name, Address and Phone number.
Your answer
Additional Comments and/or Concerns:
Your answer
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