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* 1. Do you currently need care for your children? For the purpose of this survey, "care" is defined as partial or full day services for children ages birth - 5 years and/or full day or before and after school programming for youth in grades K-12.

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* 2. If you answered "yes" to question one, what are the  number of children you need care for ages 6 weeks through Pre-Kindergarten? Please list the age of each child in the box below.

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* 3. If you answered "yes" to question one, what are the number of children you need care for in grades K through 12? Please list the age of each child in the box below.

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* 4. On a scale from 1 (extremely low regard) to 7 (extremely high regard), please rate how you regard each question below.  By regard, we mean how positively or negatively you think or feel the question applies to your needs or wants.  The more positively your need or want, the higher you would rate it. The more negatively you regard the need or want, the lower you would rate it. If the question does not apply, please leave that rating box blank.

  1-Extremely low regard 2 3 4 5 6 7-Extremely high regard
Access to Summer Day Camp programs
Access to quality, safe  School Age programs 
Access to skills development and character building programs such as Youth Sports
Access to academic enhancing programs, including Science, Technology, Reading, Engineering, Arts, and Math
Access to programs that meet special social and emotional needs
Programs that teach healthy eating habits and nutrition
Programming that includes healthy meals and snacks
Access to quality, safe Early Childhood Education/Child Care programs

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* 5. What hours do you need care for your children (select all timeframes that apply to your situation).

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* 6. If WMCA was to open a new center to provide care, what geographical areas would best fit your needs

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* 7. If you have interest in becoming involved with a Parent Advisory Group to review the results of this survey, please provide your contact information below.

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* 8. Is there anything else you'd like to share with the staff of Western Maine Community Action or the YMCA of Auburn Lewiston?

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