You are your child’s first teacher. Your home is where your child will have his or her first experiences with books and reading. Look around your home and think about what you do with your child. Please respond to each question regarding home literacy and your child's behavior to the best of your abilities. Thank you for supporting the Rotary Read Aloud Initiative.

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* 1. Your First and Last Name

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* 2.  Your Child's First and Last Name

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* 3. Child Care Provider

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* 4. Child's Teacher

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* 5. Have you participated in the Rotary Read Aloud before?

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* 6. If Yes, how many years have you participated in Rotary Read Aloud?

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* 7. Was it with the child you listed above?

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* 8. Did you read to your child while you were pregnant?

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* 9. What my child has at home...

  True False
My child has at least one alphabet book. (e.g., Dr. Seuss's ABC book)
My child has crayons and pencils readily available for writing and drawing.
My child has at least one rhyme book.
My child has more than one rhyme book.
My child has at least 20 picture books.
My child has materials and games to help learn the alphabet.

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* 10. What I or another adult do...

  True False
I or another adult in the house read a picture book with my child at least once a week.
I or another adult in the house teach new words to my child at least once a week.
I or another adult in the house have a detailed and informative conversation with my child at least once a week (e.g., “How do you think ice cream is made?)
I or another adult in the house have a detailed and informative conversation with my child nearly every day.
I or another adult in the house take my child to the library of a book store at least once every two months.

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* 11. What my child sees me or another adult doing...

  True False
I or another adult in the house read a picture book with my child at least once a week.

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* 12. What I am...

  True False
I began to read picture books with my child before he or she was a year old.
I enjoy reading picture books with my child.
I expect that my child will work to his or her potential in school.

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* 13. Now or in the past, I or another adult encourage or help my child...

  True False
I or another adult in the house encourage my child to watch beginning reading shows on TV or DVD’s. (e.g., Super Why!)
I or another adult in the house encourage my child to play with computer games that introduce the alphabet and beginning reading. (e.g., ABCya!)
I or another adult in the house help my child sing or say the alphabet.
I or another adult in the house help my child learn to name letters of the alphabet.
I or another adult in the house help my child learn to write letters of the alphabet.
I or another adult in the house help my child learn to write his or her name.
I or another adult in the house help my child learn to write other people’s names.
I or another adult in the house help my child learn how to rhyme.
I or another adult in the house help my child learn the sounds that letters of the alphabet make. (e.g., “M makes the mmmmm sound”)

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