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What is your gender?
 
Female
 
Male
 
 
What is your age category?
20-30
31-40
41-50
51-60
61-70
 
 
 
What is your marital status?
 
Single
 
Married
 
Divorce
 
Widowed
 
Separated
 
 
 
What is the highest level of education you have completed? If currently enrolled, mark the previous grade or highest degree received.
 
o No schooling completed
 
o Nursery school to 8th grade
 
o 9th, 10th or 11th grade
 
o 12th grade, no diploma
 
o High school graduate - high school diploma or the equivalent (for example: GED)
 
o Some college credit, but less than 1 year
 
o 1 or more years of college, no degree
 
o Associate degree (for example: AA, AS)
 
o Bachelor's degree (for example: BA, AB, BS)
 
o Master's degree (for example: MA, MS, MEng, MEd, MSW, MBA)
 
o Professional degree (for example: MD, DDS, DVM, LLB, JD)
 
o Doctorate degree (for example: PhD, EdD)
 
 
 
Are you currently...?
 
o Employed for wages
 
o Self-employed
 
o Out of work and looking for work
 
o Out of work but not currently looking for work
 
o A homemaker
 
o A student
 
o Retired
 
o Unable to work
 
 
 
Please specify your ethnicity.
 
o Hispanic or Latino
 
o Not Hispanic or Latino
 
 
 
Who do you contact if your child needs additional support or assistance in school?
(Only pick one)
 
Principal
 
Vice Principal
 
Teacher
 
School based support team
 
Counselor

 
 
 
What do you do if your child lacks academic performance?
   
 
 
 
What rights do you have as a parent of a Special Education child.
   
 
 
 
How do you navigate the public school system for resources?
   
 
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