Birth month and year of child (to track when they have aged out of the program). *
Your answer
Email or text number (for information about library programs for this age level, and occasional information about early literacy. This is especially important around graduation time ). *
Your answer
Does your family participate in any of the following programs? Free/reduced lunches, WIC, Head Start, EBT, Medicaid, heating assistance, food pantry, HUD. This information is for statistical purposes only and will not be shared. *
Required
I am my child's most important teacher.
Strongly agree
Strongly disagree
Clear selection
My child does not like to be read to.
Clear selection
I have to scold or discipline my child when we read.
Strongly agree
Strongly disagree
Clear selection
I feel warm and close to my child when we read.
Strongly agree
Strongly disagree
Clear selection
How often do you and/or your family members visit the library? (select one)
Clear selection
What school district do you live in?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of maryvillepubliclibrary.org. Report Abuse