Madness and Literature- Parent/Caretaker Survey- Fall 2017

The following survey will help me know more about you and your child. Most of the questions are optional.

Thank you,
Daniel Wise
English Teacher
Collegiate Institute

What is your child's grade?
What is your child's first name?
Your answer
What is your child's last name?
Your answer
What is your first name?
Your answer
What is your last name?
Your answer
What is your relationship to the student?
ex. Grandmother
Your answer
What is your phone number?
Your answer
What type of phone number is the above?
What is your email address?
Your answer
How often do you check your email?
Please write any other email addresses that we should add to our email list
For example, the email of another parent or caregiver
Your answer
PAre you comfortable with speaking any of the following languages?
Optional. This may help us communicate with other parents and potentially with guest speakers.
In which city and/or neighborhood do you and the student live?
Optional
Your answer
Do you have any skills, interests, or connections that may be of assistance to the academic or parent team? If yes, please specify.
Optional. Examples might be connections to potential guest speakers or local organizations, services that you could provide, or unique knowledge that you could share with the teachers, students, or parents
Your answer
How often do you check your child's grades online?
Which adults in the PHA community know your child really well?
This will help me reach out about ways to be of support
Your answer
In what ways can other parents be of support to you? Feel free to write any suggestions.
Your answer
What are your child's interests?
Your answer
What are your child's strengths?
Your answer
In what areas does your child struggle? How can I be of support?
Your answer
Is there anything else you would like for me to know about you or your child?
Your answer
Do you have any questions for me?
Your answer
Anything else?
Your answer
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