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Parent Pre-Program Survey
Parent survey to be fill out at the beginning of the program
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* Indicates required question
Email
*
Your email
Your Name
*
Your answer
Your Student's Name
*
Your answer
Does your child seem happy?
*
very often
often
sometimes
never
Does your child seem angry?
*
very often
often
sometimes
never
Does your child get along with brothers/sisters?
*
very often
often
sometimes
never
NA
Does your child get along with friends?
*
very often
often
sometimes
never
Does your child listen well?
*
very often
often
sometimes
never
Does your child feel good about him/herself?
*
very often
often
sometimes
never
Does your child work well on schoolwork?
*
very often
often
sometimes
never
Is your child responsible?
*
very often
often
sometimes
never
Does your child have good attendance at school?
*
very often
often
sometimes
never
Does your child behave at school?
*
very often
often
sometimes
never
Does your child have a good attitude about school?
*
very often
often
sometimes
never
What do you hope will be the benefit to your child as a result of having a mentor?
Your answer
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