HSC Planning Survey

The Nevada Head Start Collaboration and Early Childhood Systems Office, on behalf of the Nevada Early Childhood Advisory Council (“NECAC“) is working to develop a strategic plan that will allow it to achieve its vision: “Nevada’s children will be safe, healthy, and thriving during the first eight years of life, and the system will support children and families in achieving their full potential.” As part of this process we are seeking information from parents about situations and experiences of their young children (ages Birth through 8). All of the information gathered will be strictly confidential, and no association between your responses and your person will be established. If you do not know how to answer a question, or if you are not comfortable answering the question, skip it and go to the next question. There are 30 questions in this survey, which will take you approximately 10-12 minutes to complete. Also, as a result of your participation in our survey, you can request to be entered in a drawing to win a $50 gift card for books or other educational supplies! (In order to be eligible for the drawing, please complete the survey before August 28th 2013)

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* 1. What Nevada county do you live in?

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* 2. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 3. Gender:

Male

Female

Other

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* 4. Age range:

19 or younger

20-29

30-39

40-49

50-59

60-69

70 and older

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* 5. What is your ethnic background?

Anglo/White/Caucasian

Hispanic/Latino

African American/Black

Native American/Indian

Asian

Pacific Islander

Multi-racial

Other (please specify)

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* 6. What is your approximate average household income?

Less than $19,999

$20,000-$29,999

$30,000-$39,999

$40,000-$49,999

$50,000-$59,999

$60,000-$69,999

$70,000-$79,999

$80,000 and up

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* 7. What is the primary language spoken at home? (Please choose only one)

English

Spanish

Tagalog

Chinese

Other (please specify)

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* 8. What is the primary language you speak with your child currently? (Please choose only one.)

English

Spanish

Tagalog

Chinese

Other (please specify)

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* 9. How many children (0-18) are in your household?

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* 10.
Select the number of children living in your household according to their age range

	1	2	3	4	5	6
0 to 3 years old	0 to 3 years old 1	0 to 3 years old 2	0 to 3 years old 3	0 to 3 years old 4	0 to 3 years old 5	0 to 3 years old 6
4 to 5 years old	4 to 5 years old 1	4 to 5 years old 2	4 to 5 years old 3	4 to 5 years old 4	4 to 5 years old 5	4 to 5 years old 6
6 to 8 years old	6 to 8 years old 1	6 to 8 years old 2	6 to 8 years old 3	6 to 8 years old 4	6 to 8 years old 5	6 to 8 years old 6
9 to 12 years old	9 to 12 years old 1	9 to 12 years old 2	9 to 12 years old 3	9 to 12 years old 4	9 to 12 years old 5	9 to 12 years old 6
13 or older	13 or older 1	13 or older 2	13 or older 3	13 or older 4	13 or older 5	13 or older 6

11% of survey complete.

Question Title

* 1. What Nevada county do you live in?

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* 2. In what ZIP code is your home located? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 3. Gender:

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* 4. Age range:

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* 5. What is your ethnic background?

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* 6. What is your approximate average household income?

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* 7. What is the primary language spoken at home? (Please choose only one)

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* 8. What is the primary language you speak with your child currently? (Please choose only one.)

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* 9. How many children (0-18) are in your household?

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* 10. Select the number of children living in your household according to their age range

* 10.
Select the number of children living in your household according to their age range