Confidential Family Survey 2023-24 - Menchaca Elementary School
Carol Alvarez, Parent Support Specialist
Lauren Dalzin, Counselor
Marisa O'Connor, Counselor

Dear Families,

Please help us be able to meet the needs of your children by completing this confidential form.

Some Menchaca students are experiencing difficult and sensitive home situations, and we would like to find ways to help.  Please use this opportunity to share any concerns regarding your child(ren).  The information will remain confidential. 

Read the questions below and answer if any of the following issues affect your child’s ability to succeed in school. If services are available to help your child, we will contact you to share that information.  We will not discuss these issues with your child without your permission.

Thank you for your support!  It's takes a village!  Have a wonderful school year.

Sincerely,
                          Carol Alvarez 512-841-5491 carol.alvarez@austinisd.org (Hablo Español)
                          Lauren Dalzin 512-841-5524 lauren.dalzin@austinisd.org
                          Marisa O'Connor 512-841-5493 marisa.oconnor@austinisd.org
 
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Email *
Parent/Legal Guardian Name
*
Phone number
 *
Student Name(s) *
Grade
 *
Required
Teacher's Name(s)
 *
Do you have a computer at home?
 *
Do you have internet access at home?
 *
What is the preferred language at home?
 *
Are you new to the school this year? If yes, where did your child attend school last year?
Would you like information about any on the following?
Do you have a library card for the Austin Public Library System?
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Are you interested in any of the following programs /courses/workshops? Please check all that apply.
What days would you be available to take the classes?
Please note any concerns regarding family issues such as divorce, death or illness of a family member, or traumatic events in your child’s life.
Does your child have a parent or sibling who is incarcerated?
Clear selection
Do you have any close family members who have been deported, or are unable to return to the U.S.?
Clear selection
Does your child have a close family member who is in the military overseas?
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Are you a grandparent raising your grandchildren?
Clear selection
Would you like assistance with providing some clothes and/or food? *
Please note any issues or concerns that have not been mentioned above.
We would like to know your opinion about the school: (What do you like most about the school and what would you like to change?)
 *
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