Intermediate Family Survey
Dear Parent or Guardian,
We would like to know what you think about the Title I Schoolwide Program offered to your child. We would also like information about the parent involvement part of the program. The responses will be used to improve the Schoolwide Program. Please take a few minutes to complete this survey. Thank you (If you have more than one child in the building, you only need to fill it out once)
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Which school does your child(ren) attend?
My child is in the following grade: (If more than one child, choose all grades that apply)
My child had been involved in/with: (Choose all that apply)
Do you feel the services above helped your child?
My child has been involved in/with: (Choose 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 rate your choices, first, second, third and fourth
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 rate your choices first and second
First Choice
Second Choice
Grade 4
Grade 5
Grade 6
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:
Did these activities meet your needs?
Choose any of the following items that would help you attend school activities:
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 interesting in volunteering in my child's school next year.
If above, you answered yes, please provide your Name, Child's Name, Address, Phone Number
Your answer
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