JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Parent Book Club Interest Survey
This survey is to determine if parents would be interested in a book club with the school counselor. The books would be related specifically to parenting.
The book club would start first week in February.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
My Name:
*
Your answer
My email address to contact me at is:
*
Your answer
I would be interested in joining a book club
*
Yes
No
I can meet on Tuesday evenings
*
Yes
No
Other:
I would prefer to meet for this amount of time:
*
30 minutes
45 minutes
1 hour
Required
I would prefer to meet between these times:
*
4:00pm to 5:00pm
5:00pm to 6:00pm
Please Rank Book Interest
The Whole Brain Child by Daniel Siegel
Not Interested
1
2
3
Interested
Clear selection
No-Drama Discipline by Daniel Siegel
Not Interested
1
2
3
Interested
Clear selection
Parenting with Love & Logic by Foster Cline & Jim Fay
Not Interested
1
2
3
Interested
Clear selection
If not listed above, please provide suggestions below
Your answer
I will need child care:
*
Yes
No
The kids I need child care for are (ages please)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of DCSD.
Report Abuse
Forms
