Avoca CSD Family Survey of Needs During the Extended Dismissal
In light of the recent extended dismissal from school, please take a few minutes to answer the following questions regarding any special needs your family may have.
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Last name of person completing this form. *
First name of person completing this form. *
Name(s) and grade(s) of any K-12 student(s) living in your household. *
Do you have internet access available at your home? *
If you answered "Yes" to the previous question, on what types of devices are you able to access the internet? (Please check all that apply.)
During the period of the extended dismissal, the school will continue to offer food service consisting of a bagged lunch and a bagged breakfast for the following morning for all individuals 18 years of age or younger.  These meals will be distributed at locations throughout the district. Which, if any, of the following locations are you planning on picking up meals during the extended dismissal? *
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If you are planning on picking up meals during the period of extended dismissal, how many student meals do you anticipate picking up on a daily basis?
Based on the the most recent guidance from Governor's Cuomo's office and NYSED, schools or municipalities have been asked to provide childcare services to healthcare workers and first responders during the period of extended dismissal. If you work in the healthcare field, do you anticipate needing childcare services during the period of extended dismissal? *
If you answered "Yes" to the previous question regarding childcare during the current dismissal, please select the anticipated timeline for that need. The Avoca CSD has partnered with Proaction to provide these services. A representative from the school will reach out to you to assist you with arranging childcare through Proaction.  
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Please use the space below to make the school aware of any additional needs your family may have during this period of extended dismissal.
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