Back To School Survey

Student First and Last Name, age, birthdate *

Sample Question 2

Mom's Name: First and Last

Mom's Address: street, city, zip code

Mom's Phone Number with area code *

Dad's Name: First and Last *

Dad's Address: street, city, zip code *

Dad's Phone Number: Include area code *

Mom's email address *

Dad's email address *

Write things you would like me to know about yoru child. *

Do you have a computer at home with Internet Service? *

How will your child be getting to and from school? *

If you are not available, who should I contact in an emergency? *

What's the best time of day to get in touch with you? *

Are you available to help in class or chaperone field trips? Do you have any special skills or talents that you could share with the class? *

Our class will have a monthly auction of prizes ( old toys, dollar store items). Would you be able to help contribute? If so, which month of the school year would be best? *

As part of our CHAMPs reward program, we often have a "SMART JAR" filled with candy. Can you help with a bag of goodies? If so, which month of the year would be best?