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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Zip/Postal Code

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* 5. I speak to my child's teacher several times a year

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* 6. I attend school events like Meet the Teacher, Open House and Curriculum Fairs

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* 7. I am an active participant in PTA/PTSA/PTO or equivalent parent association

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* 8. I attend athletic or social events that are important to my child's school and to my child

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* 9. I know my child's friends and invite them to my home

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* 10. I know the parents of my child's friends and talk to them about our children's activities, plans and events

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* 11. I often participate with my child in social activities

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* 12. I chaperone my child's parties

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* 13. I know or meet the chaperones at the parties my child attends

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* 14. If my child's school needs a chaperone for a field trip or party, I will volunteer

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* 15. My child and I attend weekly religious service together

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* 16. We eat dinner together as a family at least 4 times a week

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* 17. I have established family guidelines for my child's behavior

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* 18. Clear guidelines are visual and posted in my home

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* 19. I take inventory of my medicines a

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