3-Week Parent Group Series

Questionnaire on Meeting Preferences

This questionnaire will help the Reach Out team understand your preferences for participating in a 3-week parent group series.

Question Title

* 1. What is your preferred language of participation?

English

German

I have no preference and am comfortable in either language.

Question Title

* 2. Which dates and times below would you be able to attend, starting the week of May 18th?

Monday midday, 11 am - 12 pm (May 18, 25 and June 8)

Monday evenings, 9-10 pm (May 18, 25 and June 8)

Thursday evenings, 9-10 pm (May 21, 28, and June 4)

Saturday afternoons, 2-3 pm (May 23, 30, and June 6)

Other (please specify)

Question Title

* 3. What are the ages of your child/children?

	0-4	5-11	12-15	16-18
First child	First child 0-4	First child 5-11	First child 12-15	First child 16-18
Second child	Second child 0-4	Second child 5-11	Second child 12-15	Second child 16-18
Third child	Third child 0-4	Third child 5-11	Third child 12-15	Third child 16-18
Fourth child	Fourth child 0-4	Fourth child 5-11	Fourth child 12-15	Fourth child 16-18

Question Title

* 4. Please share your preferred contact information, so we can confirm meeting details with you.

Name *

City/Town *

ZIP/Postal Code

Email Address *

Phone Number

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* 5. We welcome any questions/comments below:

Thank you for completing this questionnaire. We will be in touch to confirm the final details of the series once we have confirmed at least 4 participants.

The Reach Out Team
Kathy, Liz & Veronika