Manzano High School Family Needs Survey
As you answer these questions, please think about your family’s situation right now.

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Student(s) Name(s) *
Student ID Number *
Parent/ Guardian Name *
Parent/ Guardian Phone Number *
Parent/ Guardian Email Address *
Is all of your contact information correct  in Parent Vue? *
Did you have an initial virtual home visit or phone call with your students advisory teacher? *
How are you doing with food at your house? *
Required
Manznao is distributing a week's worth of breakfasts and lunches every Monday. How will you be participating in Monday breakfast/lunch boxes? *
Required
Since COVID-19, do you  have concerns with the following: *
Not at all worried
Slightly worried
Somewhat worried
Very worried
Paying Rent
Paying Mortgage
Housing vouchers
Quality of housing
Eviction
Homelessness
Paying for utilities
Losing my housing voucher
Are you aware that we have a School Based Health Center? *
Have you signed a consent form for your student to be seen at the School Based Health Center? *
Are you aware of that the School Based Health Center Provides student and Family Counseling? *
Are you are aware that the School Based Health Center offers medical and reproductive health services for students? *
Would you like someone from the School Based Health Center to reach out to you with more information about their services? *
What other supports could your student benefit from? *
Required
Understanding that the entire country has been out of school / participating in distance learning since March, how concerned are you about your child's academic progress in these subject areas? *
Not at all concerned
Slightly concerned
Somewhat concerned
Very concerned
Language Arts
Math
Science
Social Studies
Physical Education
Computer/Tech skills
Health
Fine Arts
MCL: Languages
CTE
Special Education
How does your family connect to the internet *
With Distance Learning, how worried are you about : *
Not at all worried
Slightly worried
Somewhat worried
Very worried
Getting in to class on the Chromebook or iPad
Supervision at home/daycare for my child as they do their online learning
Being able to help my child with their schoolwork
Understanding the technology
Being able to attend all the virtual class sessions
Communicating with the teacher
Communicating with the school/office
What questions or concerns do you have regarding your students academic plan? *
How can the school support you and your student(s) during distance learning? *
Additional Comments
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