January 2010 NCRJHS Parent Survey
 

Please take a few minutes to complete these demographic questions. All answers are 100% anonymous.

1. I currently have a student attending NCRJHS in the ______ grade. Choose all that apply.

2. Where did your NCRJHS student attend the sixth grade? Please choose only one answer.

3. What is your religious affiliation? Please choose the answer that best describes your family.

4. What is the zip code of your primary residence? Please enter the 5-digit zip code only.

5. What is your approximate annual household income?

6. Is your household a single or dual-income earner household? Please choose the answer that best describes the normal situation.

7. "Cafe" is the NCRJHS before and after school program. Does your family utilize either the NCRJHS "Cafe" or other before and after school childcare service?

8. What is the highest education level in your household? Please choose the answer that most closely fits your situation.

9. Which of these periodicals do you regularly read? Please select all that apply.

10. Which of the following radio and television stations do you regularly listen to? Please select all that apply.