* 1. What school do you attend?

* 2. Please check the category that applies to you

* 3. I feel welcome and accepted at my child’s school. 

* 4. The school has flexible times to allow me to meet and speak with the staff at my child’s school.

* 5. My child’s principal and/or assistant principal are available and easy to approach.

* 6. The school provides written materials in languages other than English for non-English speaking families.

* 7. I receive information on my child’s school work, test scores, and progress report.

* 8. This school involves parents in the decision-making process.

* 9. I have input into school programs and parental involvement plans through surveys or parent meetings. 

* 10. I have been given the opportunity participate in the planning of the parental involvement policy and plan.

* 11. I have been given the opportunity to review the parental involvement policy and plan. 

* 12. I have been given the opportunity to participate in the school improvement process.  

* 13. I receive information about the student code of conduct.

* 14. The school provides effective services to ensure a safe and orderly environment.

* 15.  The transportation department effectively transports students to and from school.

* 16. The food service department provides nutritious meals and snacks to students.

* 17. School rules and discipline procedures are clearly communicated to students and parents.

* 18. The school has a parent liaison available if families have questions or need assistance.  Yes or No

  Yes No
Does the work of the Parent Liaison have a direct bearing on student achievement?

Has the presence of the Parent Liaison in your school made a difference in how you feel about visiting your child’s school(s)?

* 19. I have clear information about the following required for my child’s grade or course.  Check all that apply.

* 20. In what ways are you involved in meaningful activities that support student learning.  Check all that apply.

* 21. To better support my child, I would like more information about:  Check all that apply.

* 22. What types of programs and other school context/organizational structures are needed in the school?

* 23. I receive communication from my school.  Check all that apply.

* 24. As a parent, I would like more information on the following.  Check all that apply.

* 25. Indicate the type of workshops you would like to participate in to help you help your child learn.  Check all that apply.

* 26. In order to participate in parent education programs at the school please check the time the meetings should be held. 

* 27. In order to participate in parent education programs at the school Child care needs to be provided.

* 28. In order to participate in parent education programs at the school transportation needs to be provided.

* 29. In order to participate in parent education programs at the school other special needs (interpreter for the deaf or hearing impaired needs to be provided. Please Specify.

  Yes No
Interpreter for the Deaf
Hearing impaired

* 30. Would you be interested in joining the school’s Title I planning team or P16 Community Engagement Council?  If yes, please provide your contact information below. 

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