Interest Survey

The purpose of the Interest Survey is to learn more about the students and families we serve, begin to develop a mutually beneficial relationship and set realistic expectations.

Campus
Student Name Student Name First Middle Last
Parent/Guardian Completing Survey Name Parent/Guardian Completing Survey Name First Middle Last
Family's interest, skills and favorite activities
What interesting, fun or exciting things did the student and family do most recently?
What are the student's and parents priorities for the upcoming academic school year?
LUNCH: Will your child bring breakfast/lunch from home or each school breakfast/lunch? (check all that apply)

LUNCH: Will your child bring breakfast/lunch from home or each school breakfast/lunch? (check all that apply) My child will eat school breakfast and/or lunch My child will bring lunch My child will bring breakfast My child will bring both breakfast and lunch
TRANSPORTATION: How will your child get to/from school?

TRANSPORTATION: How will your child get to/from school? Parent/Guardian Will Drive Carpool Before/Aftercare 3rd Party Provider Other
List one thing you can do to help out (talent, skill, special connections, etc.)
Email
Draw your signature into the box below.

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.