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.
What is your child's grade?
What is your child's first name?
What is your child's last name?
What is your first name?
What is your last name?
What is your relationship to the student?
What is your phone number?
What type of phone number is the above?
What is your email address?
How often do you check your email?
All the time
Once or twice a day
A couple of times a week
Once a week
Once every couple of weeks
Once a month
Once every couple of months
Please write any other email addresses that we should add to our email list
For example, the email of another parent or caregiver
Are 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?
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
How often do you check your child's grades online?
Multiple Times a Week
Once a Week
Multiple Times a Month
Once a Month
Every Few Months
We can do that???
Which adults in the PHA community know your child really well?
This will help me reach out about ways to be of support
In what ways can other parents be of support to you? Feel free to write any suggestions.
What are your child's interests?
What are your child's strengths?
In what areas does your child struggle? How can I be of support?
Is there anything else you would like for me to know about you or your child?
Do you have any questions for me?
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