1.How would you describe our local need for after school programs?

They are not needed

They are somewhat needed

They are needed

They are greatly needed

2.How would you rank our need to provide students with homework assistance?

Greatest need

Secondary need

Least needed

3.At What grade levels are after school programs most important?

Students at K-4 levels benefit from after school programs

Students in K-6 especially need after school programs

4.How likely would your family make use of after school programs?

Unlikely 

Somewhat likely 

Likely 

Highly likely 

5.If your family is likely or highly likely to participate in after school programs, how many of your children would attend?

1

2

3

4

Other (please specify)

6.Parent's name, child's name, and grade that would be attending?