Reform Elementary School Parent Interest Survey

* 1. What grade(s) are your child(ren) are this school year: (Mark all that applies)

Pre-Kindergarten

Kindergarten

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade

7th Grade

8th Grade

9th Grade

10th Grade

11th Grade

12th Grade

* 2. I prefer to be contacted by:

Phone Call

Text

Either one

* 3. I would like to receive occasional text messages on updates and reminders.

Yes

* 4. When attending meetings at school, I prefer to attend them:

In the morning

In the afternoon

In the evening

* 5. The best time to hold evening meetings is:

5:00 p.m.

5:30 p.m.

6:00 p.m.

6:30 p.m.

7:00 p.m.

* 6. I am interested in

Reading a story

Chaperoning field trips

Working with an individual student

Working with a group of students

Helping with bulletin boards

Other (please specify)

* 7. I am comfortable helping with a class activity during

Science

Math

Reading/Language Arts

Social Studies

Recess

* 8. I have an area of expertise, talent, or knowledge that I would like to share with the class.

Yes

Other (Please explain what you would like to share with the class. So I can find a way to incorporate this!)

* 9. What kinds of challenges do children who you know (in this community) face that make success in school difficult?

Difficulty with reading

Need positive adult role models

Difficulty with Math and Science

Better relationships with teachers

Physical health issues ⁭

Ways to improve behavior

Mental Health issues

Family stress

Other (please specify)

* 10. What kinds of programs and services do you think would help your children have greater success in school? (Check all that apply)

Reading Improvement Programs

Family support services

Math and Science Programs

Mentoring programs Health & Nutrition Services

Life Skills programs for students

Behavior Management programs for students

Opportunities for parents & teachers to work together for student success

Programs to help parents help their children

Mental Health Services

Other (please specify)

* 11. Mark the areas which you would be interested in discussing or having presented at future parent meetings.

How to help with homework.

Stress management—How to help your child manage school, sports, extracurricular activities, social life, etc.

How to discipline children.

How to talk to your child’s teacher (notes, parent conferences, phone calls, etc.).

How to help your child develop a positive attitude about school.

How to motivate your child to stay in school.

How to motivate your child to come to school daily.

How to help your child be on time to school and avoid tardies.

How to help your child feel good about himself and not give in to peer pressure.

How good health habits help a child learn better.

How to motivate your child to want to read and improve reading skills.

How to help your child develop good comprehension skills when reading.

How to motivate your child to do well on standardized tests such as DIBELS, Scantron, ACT Plus Writing, and ACT WorkKeys.

How to motivate your child to take the ACT beginning in the 10th and 11th grades.

How to study and study skills.

How to teach your child responsibility and consequences for actions.

Other (please specify)

* 12. Would you be willing to talk in a discussion group about student needs?

Yes

* 13. Would you be willing to work with us to develop programs & services to ensure student success?

Yes

Can’t now, but in the future

* 14. Would you be willing to talk in a discussion group about student needs?

Yes

* 15. Would you be willing to work with us to develop programs & services to ensure student success?

Yes

Can’t now, but in the future

* 16. If you would like for us to contact you regarding any of the information above, please include the following:

Your Name

Telephone Number

Email address