* 1. List the grades your child(ren) are in.

* 2. How many parent/teacher conferences have you attended
this year?

* 3. Do you feel your child(ren) receives nutritious and tasty meals?    Yes or No     If not, why?

* 4. I feel my child(ren) is safe at school.      Yes or No   
Why or why not?

* 5. Our school reflects a true sense of community?     Yes or No    
Why or why not?

* 6. What methods does the school use to keep you updated about
your child(ren)’s academic progress?

* 7. What grade would you give your child(ren)’s school?
A   B   C   D   F   Why?

* 8. What do you like about your child(ren)’s school?

* 9. What changes would you like to see at your child(ren)’s school?

* 10. How do you let the school know when your child(ren) needs
help?

* 11. Have you received the necessary help/interventions for your
child(ren) when they are needed?  Explain

* 12. What types of help/interventions have helped your child(ren) at school?

* 13. My child(ren) has been bullied at school?     Yes  or  No    
What type of bullying?

* 14. My child(ren) has been cyberbullied? (egs – Facebook, instant messaging, texting, etc.)  Yes  or  No

* 15. Did the school get involved with dealing with cyberbullying
with your child(ren)?     Yes or No

* 16. Do you feel the school dealt appropriately with your child(ren)’s bullying incident?     Yes  or  No     Why or why not?

* 17. My child(ren) is comfortable asking teachers for help.     
Yes or No     If not, why?

* 18. I feel my child(ren) likes school.  Yes or No   If not, why?

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