MWS FARMSTEAM QUESTIONNAIRE
Child's Name
First Name
Last Name
Child's Name
First Name
Last Name
Parent's Name
First Name
Last Name
Phone Number and Email Address
Relationship to the child
Please Select
Mother
Father
Grandmother
Grandfather
Step-mother
Step-father
Sister
Brother
Aunt
Uncle
Guardian
Other
How many children will be attending?
Please Select
1
2
3
1. Has your child shown interest in learning on a farm?
Yes
No
2. How often do you take your child to learn outside in Nature?
Never
1-2 times a month
Once in a few months
Once in a year
Weekly or more
3. Does your child like science related subjects?
Yes
NO
4. What would you like your child to benefit from working with Robotics and technology?
5. How well does your child work independently or with others?
Not well at all
Mildly well
Fairly well
Quite well
Extremely well
6. Rate from 1-10 What is your child's interest in Science, Technology, Engineering, Agriculture and Mathematics
7. Does your child like to learn well with hands -on or only by electronic means?
8. How often does your child read?
Never
1-2 times in a month
1-2 times in a week
3+ in a week
Everyday
9. Does your child like build or enjoy creative activities?
Yes
No
10. What county do you live?
Submit
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