Father Focus Group Registration 5/19

1

Parent / Guardian Name* This field is required.

First Name

Last Name

2

Parent / Guardian Name

First Name

Last Name

3

Parent / Guardian Email

example@example.com

4

Parent / Guardian Phone Number* This field is required.

Area Code

Phone Number

5

Co-Parent / Guardian Name

First Name

Last Name

6

Parent / Guardian Age Range* This field is required.

18 - 25 years old

26 - 34 years old

35 - 45 years old

45 - 55 years old

55 + years old

7

What county do you reside in?* This field is required.

New Castle

Kent

Sussex

Outside Delaware

8

Which event will you be attending?

May 19th

July 7th

August 11

9

Do you identify as a father or father figure?* This field is required.

Yes

No

10

How interested are you in participating in father-focused community events?* This field is required.

Very interested

Somewhat interested

Not interested

11

What would motivate you to attend an event?* This field is required.(Select all that apply)

What would motivate you to attend an event?

Incentives/gift cards

Childcare available

Convenient time

Convenient location

Relevant topics

Other:

12

If, you entered Other, please explain

13

What types of events would you attend?* This field is required.(Select all that apply)

Sporting events

Health & wellness events

Parenting workshops

Family activities (5K, games, etc.)

Community meetings

Social/networking events

Other:

14

If, you entered Other, please explain

15

Would you attend events specifically for fathers/men only?* This field is required.

Yes

No

Maybe

16

What topics are you most interested in?* This field is required.(Select all that apply)

Parenting skills

Co-parenting/relationships

Child development

Mental health

Physical health

Financial literacy

Employment/career support

Other:

17

What days/times work best for you?* This field is required.(Select all that apply)

Weekday morning

Weekday afternoon

Weekday evening

Weekend morning

Weekend afternoon

Weekend evening

Other:

18

What community resources would benefit you most?* This field is required.(Select all that apply)

Job support

Financial assistance/credit repair

Mental health services

Legal/family court support

Child support guidance

Re-entry services

Medical referrals

Other:

19

What would make father-focused programs more engaging for you?