1. Welcome

Thank you for taking time to complete this survey. We hope the information you provide will help the Youth Services Center in your school provide better programs for students and families.

* 1. What school does your student(s) attend?

* 2. Please tell us who your high school student(s) lives with

* 3. You are:

* 4. The school that student attends has a welcoming environment for parents and students:

* 5. There is effective two-way communication between home and school:

* 6. I feel comfortable speaking to school staff if I have a question or concern:

* 7. Have you communicated (by phone, e-mail, etc...) with your student(s) teachers this school year?

* 8. The staff at your student(s) school has high expectations for your student(s) :

* 9. How many times during the school year do you visit your student(s) school ?

* 10. Do you receive and read the e-mail news updates from the school ?

* 11. Do you access to a computer and the internet at home ?

* 12. How much time each week do you spend helping your student(s) with homework ?

* 13. Does your student(s) participate in school based or community based extra curricular activities ? (i.e. sports, clubs, band, choir, volunteering, etc... )

* 14. My children/family is presently without:

* 15. Please check any item that may have impacted your or your family in the past school year:

* 16. As a parent/guardian, do you feel you ever need assistance with any of the following ?

GED Preparation
Household budgeting
Parenting skills
Job Training
Literacy Trainging

* 17. My family has faced the following problems in the past six (6) months:

* 18. My family is currently involved with the following agencies:

* 19. What do you feel is the most critical need to make sure students are successful in school ?

* 20. If you would like information about the work of the Youth Services Center or would like to learn about how you can help your student(s) school, please contact the coordinator at your school, or write your comments below.