Needs Survey

Introduction

Hello Arkansas Fathers!

In order for us to stay in touch with you and to identify your needs, please complete all items in this 5 minute survey by March 10, 2023. We want to be better able to assist yo with your needs and connect you to the needed services.

https://www.surveymonkey.com/r/FNNLPXD

Part I: Basic Information Please complete the basic information below.

A. Name (Optional)

B. Please identify the type of early childhood program that serves your child/children:

Other (please specify)

D. How many children do you have and what are their ages?

F. Do you live in the home with your children?

Yes

No

Part II: Basic Needs

B. Mental Health Support

C. Education

D. Parenting

a. Education/Parenting Classes

b. Activities to do with your children

c. Meeting other fathers and families with young children

d. Co-Parenting/Single Parenting

e. Engaging in your child's education

f. Balancing work and parenting

Part III: Statewide Fatherhood Participation

B. We are in the process of interviewing fathers for our website. If you wish to participate and share your "fatherhood story", please contact Hayse Miller @ 501-372-4242/hmiller@fsainc.org or Jackie Govan @ 501-371-0740/jackie.govan@arheadstart.org.

Part IV: Fatherhood Resources and Brochure Distribution

A. We have the following resources available, please check all that you are familiar with:

B. If you would like more information on any of the resources below, please check the boxes below and put your email and phone number below:

Fatherhood Brochure

Fatherhood Mission/Vision Statement

Online Resources

List of Upcoming Events and Activities

Other (please specify)

Email

Phone Number

Part V: Other Areas

A. Please identify other needs or areas that you would be interested in hearing more about.

B. Please list any questions or comments that you may have regarding our fatherhood program.

HSSCO-J. Govan

QR Code to complete the survey electronically.