1. JOHNSON O'MALLEY PARENT/GUARDIAN SURVEY  ~  TO BE COMPLETED ONLY ONCE.

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* 1. Please indicate number of children enrolled in Bloomfield School District. (An answer is required for each shcool, Example> 1, 2, 3, 10).

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* 2. I am familiar with the JOM program and how it supplements the needs of our Native American students.

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* 3. Should the JOM Program continue to assist students with school supplies?

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* 4. I am familiar with the Parental Cost Shares offered to my child/children in meeting his or her educational needs.

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* 5. The implementation of Dine’/Native American Culture, Government/History is critically important.

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* 6. In our home, we teach the Dine’/Native American culture and language.

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* 7. Effective Dine’ Language and Culture Programs are taught throughout the District.

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* 8. I understand the Indian Education Federal Grant Title VI – Impact Aid is a part of my child’s education as part of the Indian Education Federal Grants.

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* 9. My child/children’s school has a positive cultural climate.

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* 10. My child/children’s school has access to Dine/Native American language classes.

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* 11. Native American children that attend Bloomfield Schools are given the opportunity to participate on an equal basis in regard to the extra-curricular programs.

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* 12. I understand my child needs CIB and 506 forms on file to qualify for JOM services.

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* 13. My child/ children need more access to afterschool tutoring and extended year programs.

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* 14. Teachers, principals, and other school officials are receptive to suggestions in regard to the special needs affecting the educational programs of the Indian students.

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* 15. Bloomfield School District has effectively ensured the Navajo Nation Tribal Clothing program is implemented and supported for those eligible students.

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* 16. Jr. High & High School only: Native Youth Advisors are helpful and supportive in meeting the needs of my child/children.

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* 17. Comments: 

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