ROE #35 Needs Assessment for Parents
This survey is being used as part of a needs assessment for a Community Partnership grant awarded to the Regional Office of Education #35 which covers LaSalle, Marshall, and Putnam counties. The results of this survey will be used in creating, implementing, and evaluating our Student & Family Wellness Program which will launch at the beginning of the 2022-2023 school year. Your response is appreciated!

If you have questions please reach out to Virginia Campbell at vcampbell@roe35.org or Kassidi Guerrero at kguerrero@roe35.org.
Sign in to Google to save your progress. Learn more
Do the children in your family currently participate in an after school program?
Clear selection
If you answered "No", which answer best describes the reason?
Clear selection
Do you have plans for the children in your family to participate in summer programming like day camp or community recreation, etc.?
Clear selection
If you answered "No", which answer best describes the reason?
Clear selection
Does your family have a membership to the YMCA?
Clear selection
If you answered "No", which answer best describes the reason?
Clear selection
Do you have concerns about the physical health, mental health, wellness, or academic progress of the children in your family?
Clear selection
If you answered "Yes" to the above question, what area are you most concerned about?
Clear selection
Would you, as a parent/caregiver, be interested in opportunities to learn about mental health and wellness issues related to children and youth?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of LaSalle ROE 35. Report Abuse
Google Forms