CY Team - School's Out COVID-19 Response Survey

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* 1. What is your name?

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* 2. Please provide your contact information

Email Address

Phone Number

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* 3. Are you currently home with your children?

Every Day

Most of the time

Sometimes

Rarely

Other (please specify)

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* 4. Are you an essential service worker and in need of childcare support?

Yes

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* 5. Please indicate which age groups you are looking for programming?

0-5

6-8

9-12

13-18

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* 6. What themes of programming would you like us to offer? Do you have any specific areas that you would like us to target?

Physical Literacy

Academic Literacy

Culinary

Science Experiments

Specific areas here:

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* 7. Do you have access to the internet?

Yes

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* 8. I have access to the following:

Personal Computer

Tablet

Smartphone

Printer

If multiple, which ones

CY Team - School's Out COVID-19 Response Survey

Question Title

* 1. What is your name?

Question Title

* 2. Please provide your contact information

Question Title

* 3. Are you currently home with your children?

Question Title

* 4. Are you an essential service worker and in need of childcare support?

Question Title

* 5. Please indicate which age groups you are looking for programming?

Question Title

* 6. What themes of programming would you like us to offer? Do you have any specific areas that you would like us to target?

Question Title

* 7. Do you have access to the internet?

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* 8. I have access to the following:

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* 9. What other supports do you need during this time? (food, parenting resources, etc.)

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* 10. Do you have any additional comments or questions?