Support Survey

Parent of one MPS student

Parent of multiple MPS students

Support staff (para, administrative assistant, etc)

Teacher

Other (please specify)

Yes, from one of the school meal distribution centers

Yes, from one of the school bus delivery routes

No, we can't get to the distribution centers or bus routes

No, we are choosing not to receive meals

Yes, basic pantry items would help to make ends meet.

No, we have enough for now.

Yes, we need cleaning items (dish soap, laundry care, paper towels, etc).

Yes, we need personal care items (soap, shampoo, diapers, etc).

Yes, we need both cleaning and personal care items.

No, we have what we need right now.

Yes, we need supplies for a student in K-3.

Yes, we need supplies for a student in 4-5.

Yes, we need supplies for a student in 6-12.

No, we don't need any school supplies.

We need supplies for more than one student (please describe)

Yes, we are. We need some help or resources to manage stress right now.

Yes, we are. We have the help or resources we need to manage stress right now.

No, we aren't feeling anxious or stressed right now.

Other (please specify)

Name

Address

City/Town

State/Province

ZIP/Postal Code

Phone Number