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* 1. I am a ....

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* 2. In what grade(s) is/are your child/children in? (mark all that apply)

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* 3. Based on your experience, how strongly do you agree or disagree with the following statements about this district?

This district....

  Strongly Agree Agree Disagree Strongly Disagree Don't Know/NA
promotes academic success for all students.
treats all students with respect.
gives all students opportunities to "make a difference" by helping other people, the school, or the community.
keeps me well-informed about school activities.
provides quality counseling or other ways to help students with social or emotional needs.
is a supportive and inviting place for students to learn.
communicates the importance of respecting different cultural beliefs and practices.
provides instructional materials that reflect my child's culture, ethnicity, and identity.
enforces rules equally for my child and all students.
has quality programs for my child's talents, gifts, or special needs.
is a safe place for my child.
promptly responds to my phone calls, messages, or e-mails.
encourages me to be an active partner with the district in educating my child/children.
actively seeks the input of parents before making important decisions.
has clean and well-maintained facilities and properties.
provides high quality instruction to my child/children.
motivates students to learn.
has teachers who go out of their way to help students.
has adults who really care about students.
has high expectations or all students.
encourages students to care about how others feel.

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* 4. Based on your experience, how much of a problem in this district is ...

  Not a problem Small problem Somewhat a problem Large problem Don't know/NA
student tobacco use (cigarette smoking and/or smokeless tobacco such as dip, chew, or snuff)?
student vaping or e-cigarette use?
student alcohol and drug use?
harassment or bullying of students?
physical fighting between students?
racial/ethnic conflict among students?
students not respecting staff?
gang-related activity?
weapons possession?
vandalism (including graffiti)?

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* 5. Since the beginning of the school year, has any adult in your child's household done any of the following at your child's school? (mark all that apply)

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* 6. How well have the schools been doing the following during this school year?

  Very Well Just Okay Not Very Well Does Not Do It At All Don't Know/NA
Letting you know how your child is doing in school between report cards.
Providing information about how to help your child/children with homework.
Providing information about why your child is placed in particular groups or classes.
Providing information on your expected role at your child's school.
Providing information on how to help your child/children plan for college or vocational school.

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* 7. How strongly do you agree or disagree with the following statements?

  Strongly Agree Agree Disagree Strongly Disagree Not Sure/NA
My child's teachers are responsive to my child's social and emotional needs.
My child/children is/are receiving adequate instruction from teachers to support assigned work.
My child/children is/are motivated to complete their assigned schoolwork.
My child/children feel(s) hopeful about the future.
Our school provides parents with advice and resources to support my child's social and emotional needs.

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* 8. How do you rate the meals provided by the district?

I Hate Them I neither hate nor love them I Love Them
Clear
i We adjusted the number you entered based on the slider’s scale.

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