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Parent Education Survey

Name
What was the name of the class you attended?
2. Caregiver Type
6. How did you register for this class?
Please provide us with some information about you by checking the appropriate boxes.
Race/Ethnicity: Please check the boxes that best describe your race and ethnicity. *Hispanic is considered an ethnicity, not a race. If you describe yourself as Hispanic you must also declare one race category.
Income Level
Please select the income range that best describes the total income of your household:
Age:
Gender
Disability
Check here if you have a disability. (Mental, behavioral, substance addictions, developmental and/or physical)
1. As a result of attending this parenting class I feel more confident in my abilities as a parent in supporting my child’s safety, health and well being.
2. As a parent I know how to find information and resources about child development and health as well as additional support for parents and families.
Parent Education Survey

Parent Education Survey

Name
What was the name of the class you attended?
2. Caregiver Type
6. How did you register for this class?
Please provide us with some information about you by checking the appropriate boxes.
Race/Ethnicity: Please check the boxes that best describe your race and ethnicity. *Hispanic is considered an ethnicity, not a race. If you describe yourself as Hispanic you must also declare one race category.
Income Level
Please select the income range that best describes the total income of your household:
Age:
Gender
Disability
Check here if you have a disability. (Mental, behavioral, substance addictions, developmental and/or physical)
1. As a result of attending this parenting class I feel more confident in my abilities as a parent in supporting my child’s safety, health and well being.
2. As a parent I know how to find information and resources about child development and health as well as additional support for parents and families.
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