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* 1. Topic:

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* 2. Are you a (check all that apply)

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* 3. What is your race/ethnicity?

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* 4. What is your gender identity (male/female/transgender/non-binary/etc.)?

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* 5. What is your age?

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* 6. What grade is your child in or what grade do you work with (check all that apply)?

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* 7. Which school does your child attend or what school do you work with (check all that apply)?

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* 8. How many people viewed this presentation in your home?

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* 9. Was this topic relevant?

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* 10. I feel like I learned new skills and information in this presentation.

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* 11. I can apply the things I learned in this presentation into my parenting or work with youth.

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* 12. What did you learn?

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* 13. Describe three ways in which you could apply this to your parenting or work with young people?

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* 14. What other questions do you have on this topic?

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* 15. What other topic would you like included in parent education dinners or community trainings?

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* 16. Are there other ways we can improve in the future? 

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* 17. What is your first and last name? (If you are doing this for Choice Pass parent education) 

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* 18. What is your child's/children's first and last name? (If you are doing this for Choice Pass parent education) 

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