Parent Survey Feb 2012
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1
. Contact Information
Contact Information
Name:
City/Town:
Email Address:
Phone Number:
2
. How Did You Hear About the Special Needs Parent Committee?
How Did You Hear About the Special Needs Parent Committee?
School/District Website?
Flyer?
Friend/Other Parent?
School Employee?
Email?
Other (please specify)
*
3
. Age of Child with Disability: __________ Grade In School: _________
Age of Child with Disability: __________ Grade In School: _________
4
. Does Your Child Have?
Does Your Child Have?
IEP,
504,
Neither
5
. Please select the top 4 workshops/discussions you would be likely to attend
Please select the top 4 workshops/discussions you would be likely to attend
IEPs & 504 Plans
Understanding the Special Education Process
Inclusion
Nutrition
Parent Teacher Conferences
Understanding Evaluations
Camp Fair
Transition to Work and Independent Living
Reading Programs
SibWorkhop
School Discipline
Sensory Integration
Recreation & Leisure
Bullying
Challenging Behaviors
Understanding My Child’s Learning
Parent Advocacy
Disability-Specific Best Practices
Support Group
Building a Community
Inclusion for Children with Emotional/Behavioral Challenges
Other (please specify)
6
. How many workshops a year do you believe we should sponsor (topic driven)
How many workshops a year do you believe we should sponsor (topic driven)
One
Two
Three
7
. How many workshops would you anticipate attending each year (topic drive)?
How many workshops would you anticipate attending each year (topic drive)?
One
Two
Three
8
. How many general meetings do you believe we should sponsor (i.e. open discussion, support, less topic driven)
How many general meetings do you believe we should sponsor (i.e. open discussion, support, less topic driven)
One
Two
Three
9
. When are you most likely able to attend a workshop?
When are you most likely able to attend a workshop?
Anytime During The School Day
Morning
Afternoon
Evening
10
. Would you be willing to serve in a leadership position?
Would you be willing to serve in a leadership position?
Board Member (1-2hrs/wk) (i.e. Secretary, Programs, Outreach, Communication, Recreation, School Liaison Officer, Co-Chair)
Workgroup/Program chair (varies based on program)
School Level Special Needs Representative (1-2 hrs/mo)
School Child will be enrolled in F2012
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