Parent intersession survey

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1. Default Section

1. Your Student's name (optional):

Your Student's name (optional):

2. Which of the following did your child do while on intersession break? Check ALL that apply:

Which of the following did your child do while on intersession break? Check ALL that apply: Played with friends

Attended a camp or program

Took a class

Played an organized sport

Did some other physical activity like swimming, bike-riding, running

Traveled

Played video games

Watched TV

If your child attended a camp or program, took a class, or played a sport, please describe briefly here:

3. Which of the following best describes where your student was most of the days while s/he was on intersession:
Check ONE:

Which of the following best describes where your student was most of the days while s/he was on intersession: Check ONE: At home with a parent

At home with another relative

At home with a babysitter or nanny

At home alone

At someone else’s house – a relative or friend

Attended a camp or program

Away on vacation or other trip

At parent’s work

Other (please specify):

4. Would you be interested in having your student attend an intersession program at the school if it were offered?

Would you be interested in having your student attend an intersession program at the school if it were offered? Yes

5. What elements of a program would most interest you? Please feel free to check as many as you would like:

What elements of a program would most interest you? Please feel free to check as many as you would like: Help with academic skills (like reading comprehension, math, etc.)

Academic enrichment courses (like environmental studies, drama, engineering, creative writing, etc.)

Help with study skills

Recreational activities

Community-building activities

Organized sports

Arts

Field trips into the community

Community service

Character education

Other (please specify)

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