Home Visit Family Survey

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Your Name

Building(s) my child(ren) are enrolled

ECC

ELE

Who visited you?

I believe today's home visit will help my child(ren) with:

choose as many as you'd like

Improved student attendance

Improved student achievement

Increasing student test scores

Improved attitudes about school

Increased parent and family involvement

Improved classroom behavior and self-discipline

I have a positive relationship with my child’s teacher.

Strongly Disagree

Strongly Agree

Clear selection

I feel welcomed in MRH Schools.

Strongly Disagree

Strongly Agree

Clear selection

My child feels welcomed in MRH Schools.

Strongly Disagree

Strongly Agree

Clear selection

Family Engagement

Have you had opportunities to be involved in the school events?

Yes

Maybe

Not yet (it's my first time)

Clear selection

What kind of involvement opportunities at school events are you most interested in?

Volunteering during the event

Contributing skills or talents

Leading or co-leading an activity/station

Providing feedback and suggestions

Attending and supporting my child(ren)

Other:

What day of the week works best for your family to attend school events?

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

What time of day or day of the week works best for your family to attend school events?

Morning

Afternoon

Early Evening (4 - 6pm)

Late Evening (7 - 9pm)

Are there any barriers that prevent you from attending school events?

Family Responsibilities and Time Constraints

Work schedules

Transportation

Lack of Childcare

Language Barriers

Work Schedule Conflicts

Other:

Other Comments:

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This form was created inside of MRH School District.