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* 1. Expanded Learning/Enrichment Opportunities for students.(Please check all items you are interested in)

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* 2. Academic Supports for Students.(Please check all items you are interested in)

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* 3. Health and Mental Services for Students. (Please check all items you are interested in)

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* 4. Social/Emotional Supports for Students at School. (Please check all items you are interested in)

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* 5. Preferred Supports for Families. (Please check all items you are interested in)

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* 6. Preferred Resources for Families and Parents(Check all that apply)

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* 7. What is your gender?

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* 8. In what language do you speak most fluently?

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* 9. Your relationship to Dr. Week's Elementary School

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* 10. May we invite you to future discussion regarding the community school and/or request your input regarding the services and programs that you and your family can benefit from?

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