A.Who is answering the survey? (Choose one.) Mother Father Stepmother Stepfather Aunt Uncle Grandmother Grandfather Other realtive Guardian Other (describe)
B.Name of School: City Location:
C.How many teens in your family go to this school this year (Choose one.) 1 2 3 4 5 or more
D. What grades are they in? Check boxes for all of the grades of your teens in this school. pre-K Kindergarten Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 12 Other
If you have more than one teenager in this school, please answer the questions in the survey about your oldest teen in this school. If you have a teenager in this school with an IEP, please answer the survey about your oldest teen with an IEP in this school. A IEP, or individualized Eduaction Program, is a written description of the special education and related services to be provided to a student with disabilities.
E. Is your oldest teen in this school ... a boy a girl
F. Is the teen you are answering for a student with an IEP? yes no
1. We would like to know how you feel about this school right now.This will help us plan for th future. Please select one choice for each statement.
How much do you agree or disagree with each of the following?
a. This is a very good school. Agree Strongly Agree A Little Disagree A Little Disagree Strongly
b. The teachers care about my teen. Agree Strongly Agree A Little Disagree A Little Disagree Strongly
c. I feel welcome at the school. Agree Strongly Agree A Little Disagree A Little Disagree Strongly
d. This school has an active parent organization (e.g., PTA/PTO). Agree Strongly Agree A Little Disagree A Little Disagree Strongly
e. My teen talks about school at home. Agree Strongly Agree A Little Disagree A Little Disagree Strongly
f. My teen should get more home work.
Agree Strongly Agree A Little Disagree A Little Disagree Strongly
g. Many parents I know help out at the school.
h. The school and I have diffrent goals for my teen.
i. I feel I can help my teen in reading.
j. I feel I can hel my teen in math.
k. I could help my teen more if the teacher gave me more ideas.
l. My teen is learning as much as he/she can at this school.
m. Parent at this school get involved more in the younger grades.
o. The school views parents as important partners.
p. The community supports this school.
q. This school is one of the best schools for students and parents.
r. This school is a safe place.
a. Talked to my teen about school never 1-2 Times A Few Times Many Times
b. Visited my teens school
c. Listened to my teen read something he/she wrote.
d. Helped my teen with homework.
e.Praticed spelling or other skills before a test.
f. Talked with my teen abuot a TV show.
g. Helped my teen plan time for homework and chores.
h. Talked with my teen's teacher at school.
i. Talked with my teen's teacher on the phone.
j. Went to PTA/PTO meetings.
k. Checked to see if my teen has done his/her or homework.
l. Volunteer at the school.
m. Went to special events at school.
n. Attend a sport event, hign school play, concert, or other peformance/activity with my teen.
o. Talked with my teen about how inportant school is.
p. Talked with my teen about future plans for college or work.
q. Dicussed grades on test & homework.
r. Talked with my teen about health.
s. Talked with my teen about future plans for college work.
t. Helped with/talked about a homework assigment.
4. Some families want to attend workshops or classes on topics they want to hear more about. Fill in the ones that intersts you...or suggest a few... How children grow and develop at my teen's age How to discipline teens Solving school problems and preventing drop out Preventing health problems How to deal with stress Understanding special education procedures Raising teens as a single parent How to help my teen develop his/her talents Helping teens take tests Understanding schools How to serve on a school committee or council Other topics you want?
4a. In the past year, did you attend a workshop or class at the school? No Yes On what topic?
5. Schools contact families in different ways. Fill in one choice to tell if the school has done these things this year. This school...
A.helps me understand my teen's stage of developmen Does Not Dot Could Do Better Does Well
B.tell me how my teen is doing in school. Does Not Dot Could Do Better Does Well
C.tells me what skills my teen needs to learn each year. Does Not Dot Could Do Better Does Well
D.has a parent-teacher conference with me. Does Not Dot Could Do Better Does Well
E.explains how to check my teen's homework. Does Not Dot Could Do Better Does Well
F.sends home news about things happening at school. Does Not Dot Could Do Better Does Well
G.gives me information about how report card grades are earned. Does Not Dot Could Do Better Does Well
H.assigns homework that requires teens my teen to talk with me about things learned in class. Does Not Dot Could Do Better Does Well
I.sends home clear notices that I can read easily. Does Not Dot Could Do Better Does Well
J.contacts me if my teen is having problems. Does Not Dot Could Do Better Does Well
K.invites me t programs at the school. Does Not Dot Could Do Better Does Well
M.asks me to volunteer at school. Does Not Dot Could Do Better Does Well
L.contacts me if does something well or improves. Does Not Dot Could Do Better Does Well
N.invites me to PTA/PTO meetings. Does Not Dot Could Do Better Does Well
O.asks me to help with fund raisers. Does Not Dot Could Do Better Does Well
P.includes parents on school committees such as cirriculum, budgets, and school improvement. Does Not Dot Could Do Better Does Well
Q.provides information on community services that i may want to use. Does Not Dot Could Do Better Does Well
R.responds to my concerns & requests within a reasonable time. Does Not Dot Could Do Better Does Well
S.helps me talk with my teen about health-related issues. Does Not Dot Could Do Better Does Well
T.gives me information on how my teen may qualify for scholarships or loans for college. Does Not Dot Could Do Better Does Well
U.provides information on how to help my teen plan for college or work. Does Not Dot Could Do Better Does Well
V.provides useful information to me/my teen about post-secondary education Does Not Dot Could Do Better Does Well
6.All communities have information that would help families. Which services in your community would you like know more about? Fill in the information you want. Health care for children and famililes family counsieling job training for parents/adults adult education parental classes information on museums,shows,andevents in the community after-school sports activites other after-school clubs or lesson to develop talents commuinty service that children can do summer programs for children after-school tutoring child care other(describe the commuinty information you need):
7.over the past two years, how much has school involved you at school and at home? the school has involed me less this year than last. the school has involed me about the same in both years. the school has involed me more this year than last. my child did not attend this school last year.
8. about homework.(fill in on choice for each questions.)
a. About how much time dose your teen spend doing homework on most school days? Minutes my teen does homework on most school days: None 5-15 16-30 31-45 46-60 Over 1 hour
b. How much time do you spend helping your teen with homework on an average night? Minutes of my time: None 5-15 16-30 31-45 46-60 Over 1 hour
c. How much time could you spend working with your teen if the teacher showed you what to do? Minutes I could spend: None 5-15 16-30 31-45 46-60 Over 1 hour
d. Do you have time on weekends to work with your teen on projects or homework or school? Yes No
9. About Your Teen and Family
a. How is your teen at this school doing in his/her schoolwork? Outstanding student Good student OK, Average student Fair student Poor student
b. How does your teen at this school like this year? Likes school a lot Likes school a little Does not like school much Does not like school at all
c. How often does your teen at this school deliver notices home on time? Always Usually Once in a while Never
d. How often at this school dose your teen at this school complete all homework one time? Always Usually Once in a while Never
e. When can you attend conferences, meetings, of workshops at this school (Fill in al that apply)? morning Afternoon Evening Cannot ever attend
f. How many adults live at home (including your self)? 1 2 3 4 5 or more
g. How many children live at home? 1 2 3 4 5 or more
h. What is your hignest level of education? Did not complpete high school Completed high school Some college or traninig College degree
i. Are you employed now Employed full-time Employed part-time Not employed now
10. Any other ideas or suggestions? PLEASE NOTE: Your response to this question will be communicated to the school by being copied.
Designed by D. M. Therrell Technology Club and ©2001-2002