Belonging & Voice - Family Survey 
Thanks for engaging with our Belonging & Voice community. We value your time and energies to share your perspective and voice with us. 

This is a place to share your thoughts: What's working and/or could be improved for your student/family's experience in MISD.

Please fill out one form for each student, but one form for your entire family is also great if that's all the time you have. 

This form may be submitted anonymously. 

Note that the Belonging & Voice Committee is affiliated with the Mercer Island PTA Council. We are a community of parent volunteers who work to connect with the parent/family community to better support and advocate for deeper Belonging for students and families in our school district. 
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My student / family feels valued and accepted in our school community on Mercer Island. 
*
Agree
Disagree
If there is a question or concern, I feel comfortable sharing it with leaders in the school community. ( teacher/staff member, principal or parent community leaders) *
Agree
Disagree
One thing the school does well for my student / our family is... *
Required
One wish I have for school to improve my student's experience is... *
Required
What are some actions a teacher or staff member used to help your student/family feel welcome and increase their sense of belonging?
Is there a specific staff member who has made a difference to help your student/family feel valued and cared for?

Please share who they are and what did they do to support your student/family?
Has your student experienced an instance of bias, discrimination, or issue related to race, culture, language, gender, ability or identity? 
When the instance above occurred, how did your family choose to respond? 
My student(s) attend the following schools. (Check all that apply) *
Required
OPTIONAL: 
Please let us know if your family shares any of the demographics below. This information will help us better understand the needs of specific populations.
Any other comments?
If you're open to sharing more with us or would like follow-up, please leave your name and/or contact information below. 
Email and/or Phone # 
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