PARENT SURVEY
FAMILY SERVICES DIVISION (This information will be used to determine future enrollment and services needed by families.)
How many children are in the home under the age of 5?
*
Do you plan to re-enroll your child for 21/22 school year in Head Start/Early Head Start?
Yes
No
Does your family consist of children who are, or will be attending public or private school?
Yes
No
If yes, how many?
What schedule would best accommodate your family’s needs for Head Start/Early Head Start?
Monday - Friday 7:30 to 2:00 Head Start: 7:30 to 3:30 Early Head Start
Tuesday - Friday (Public School schedule) 7:30 to 3:00 Head Start: 7:30 to 4:00 Early Head Start.
Do you, or do you have a family member or friend, who would consider Early Head Start Enrollment (age six weeks to 3 years) if available in your community?
Yes
No
Please rank the importance of Head Start Bus Transportation for your family.
Very important (Child would not attend Head Start without bus transportation.)
Most important ( Bus transportation is preferred but other transportation is available if needed.
Not needed (Transportation is available daily.)
Submit
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