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* 1. My gender is: 

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* 2. My age is: 

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* 3. The student I’m completing this survey for attends _____.

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* 4. The school maintains a safe environment.

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* 5. The school maintains a pleasant learning environment.

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* 6. Communication (amount and information) from the school district is adequate.

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* 7. Communication (amount and information) from the school is adequate.

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* 8. Communication (amount and information) from the teachers is adequate.

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* 9. I am satisfied with the curriculum (what my child studies and learns).     

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* 10. Homework assignments are meaningful.

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* 11. The amount of time spent on homework is appropriate.

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* 12. Teachers meet the needs of individual students.

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* 13. My child is a/an _____ reader.

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* 14. My child is a/an _____ writer.

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* 15. My child reads at home in order to complete school assignments.

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* 16. My child checks out books from the school library or accesses them online.

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* 17. My child has lists of words that he/she studies at home for school assignments.

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* 18. My child writes original pieces for school assignments (stories, essays, etc.).

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* 19. My child takes and/or studies notes for school assignments.

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* 20. My child does research for school assignments.

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* 21. My child’s favorite subject/class is _____.

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* 22. What else would you like for us to know? Comments about literacy instruction are most welcome.

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