Figure 2.4    Sample Parent Survey

Dear parent or guardian:
Please help us gain more information about how we as a school are doing at supporting you and your child. Please complete the survey and feel free to put any additional comments or concerns on the back of this form.

AREA OF SERVICE	QUALITY RATING	

OVERALL IMPRESSIONS	Strongly agree	
Agree	
Neutral	
Disagree	Strongly disagree	Don't know	
Our school provides a quality education for your child.	1	2	3	4	5	6	
Our school is doing an excellent job teaching:							
Reading	1	2	3	4	5	6	
Writing	1	2	3	4	5	6	
Math	1	2	3	4	5	6	
Science	1	2	3	4	5	6	
Physical Education	1	2	3	4	5	6	
Fine Arts	1	2	3	4	5	6	
I communicate well with my child’s teacher.	1	2	3	4	5	6	
SCHOOL RESOURCES	
The school provides my child with everything that he or she needs to learn.	1	2	3	4	5	6	
The school building is well maintained and appropriate for learning.	1	2	3	4	5	6	
LIFE SKILLS TRAINING	
My child receives education on social skills that will help him or her be  successful.	1	2	3	4	5	6	
The school does a good job preparing my child for the future.	1	2	3	4	5	6	
I believe the school does a good job preparing all children for the future.	1	2	3	4	5	6	
BEHAVIOR	
I believe the children in the school treat each other respectfully.	1	2	3	4	5	6	
I understand the school discipline policies.	1	2	3	4	5	6	
Children in our school are culturally sensitive.	1	2	3	4	5	6	
Staff at the school are culturally sensitive.	1	2	3	4	5	6	
The structure of the school day and activities helps the children learn.	1	2	3	4	5	6	
Staff at the school care about my child.	1	2	3	4	5	6	
PARENT-SCHOOL COMMUNICATION	
As a parent I feel welcome in the school.	1	2	3	4	5	6	
As a parent I feel my opinion is taken seriously at the school.	1	2	3	4	5	6	

Note: Clipart from Clipart.com.

Retrieved from the companion website for Authentically Engaged Families: A Collaborative Care Framework for Student Success  by Calvalyn G. Day. Thousand Oaks, CA: Corwin, www.corwin.com. Copyright ã 2016 by Corwin. All rights reserved. Reproduction authorized only for the local school site or nonprofit organization that has purchased this book