1.Are you… (select all that apply)

Parent/Guardian

Student

KUSD Employee

Community Member

None of the above

2.Name of your community

Kayenta

Shonto

Oljato

Dennehotso

Other

3.Which school does your child(ren) attend?

PreK-Kindergarten

Kayenta Elementary School (1-4)

Kayenta Middle School (5-8)

Monument Valley High School (9-12)

None of the above

4.Looking at the list, please choose and rank student needs from the highest to lowest by checking the appropriate number:

Very Important/Important/Least Important

Dine Culture/Language

-- Select an option --Very ImportantImportantLeast Important

Dine/Native Cultural Arts

-- Select an option --Very ImportantImportantLeast Important

Math

-- Select an option --Very ImportantImportantLeast Important

Writing

-- Select an option --Very ImportantImportantLeast Important

Reading

-- Select an option --Very ImportantImportantLeast Important

Technology

-- Select an option --Very ImportantImportantLeast Important

Fine Arts/Dance/Music

-- Select an option --Very ImportantImportantLeast Important

STEM (Science, Technology, Engineering, & Mathematics)

-- Select an option --Very ImportantImportantLeast Important

Career & Technical Education (CTE)

-- Select an option --Very ImportantImportantLeast Important

College & Career Readiness

-- Select an option --Very ImportantImportantLeast Important

Safety/Health Wellness

-- Select an option --Very ImportantImportantLeast Important

Family Engagement

-- Select an option --Very ImportantImportantLeast Important

Assistance (glasses, caps & gowns, ACT FEES, etc...)

-- Select an option --Very ImportantImportantLeast Important

Other

-- Select an option --Very ImportantImportantLeast Important

5.If other, please specify:

6.Share your ideas or current enriching Dine Culture and Language experiential learning activities our student benefits or will benefit from:

7.Are you interested in learning more about JOM activities at KUSD?

Yes

No

8.To share news about the Districts JOM Program, what is the best way to contact you? Select at least 1 and no more than 6.

School Website 

Social Media (i.e., Facebook, Instagram, Twitter, YouTube, etc...)

School All-Call Radio

Phone call

Email

Letter Mailing

Flyers

Mass Text

9.Have you applied for assistance under the Johnson O'Malley Program?

Yes

No

10.What assistance did you requested for under the Johnson O'Malley Program?

Eye Glasses

Cap and Gown

School Supplies

Test Fees

None of the above

11.Please provide us your feedback or questions about the Johnson O'Malley Program?