Mrs. Novak's Home Survey 2019-2020
You are an expert on your child, please fill out the following information to help me know and understand your child.
Email address *
Student Last Name *
Your answer
Student First Name *
Your answer
Student Nickname
Your answer
Parent/Guardian First and Last Name *
Your answer
Contact Number(s) *
Your answer
Who does your child live with? *
Who else lives in the home?
Your answer
Preferred Email *
Your answer
Other Email
Your answer
Other Email
Your answer
Best Point of Contact *
Do you have internet access at home? *
Primary language spoken at home. *
Please describe recent family events or changes (i.e. death, new sibling, divorce, moving, etc.)
Your answer
Do you have any special concerns about your child (academically, socially, medically, etc.)?
Your answer
Tell me about your child's interests and after-school activities.
Your answer
My child approaches learning with (check all that apply) *
Required
Briefly tell me about your child's experience in school last year.
Your answer
My child's concerns for this year
Your answer
Would you like to become involved in the classroom or school? *
Please provide any other information I may need to know about your child.
Your answer
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