IKIC Parent Survey - One submission per student will be accepted for the drawing

Question Title

* 1. Parent First & Last Name

Question Title

* 2. Student First & Last Name

Question Title

* 3. School

Question Title

* 4. Preferred Phone Number (to contact if you win):

Question Title

* 5. Preferred Email (to contact if you win):

Question Title

* 6. Street Address/PO Box:

Question Title

* 7. City:

Question Title

* 8. Zip Code:

Question Title

* 9. I read and discussed the I Know I Can book with my child.

Yes

No

Question Title

* 10. I asked my child about his/her dream career.

Yes

No

Question Title

* 11. I discussed with my child what education the career may require.

Yes

No

Question Title

* 12. I helped my child with the activities at the end of the book.

Yes

No

Question Title

* 13. Please tell us what you think of this program: