Indicate Availability for Interview: Parent/Caretaker

If you are available to participate in a one-hour virtual interview and receive a $100 Amazon gift card, please enter your name and email address. These will not be connected to your survey results.

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* Name

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* Stakeholder Role (please check all that apply)

Parent.

Caretaker.

Grandparent.

Other (please describe)

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* Grade level. Please indicate the grade level of your child or children in the 2021-2022 school year. Please check all that apply:

Preschool.

Kindergarten

Primary elementary (grades 1 to 3)

Upper elementary (grades 4 to 5/6)

Middle (grades 5/6 to 8)

Secondary (grades 9-12)

Indicate Availability for Interview: Parent/Caretaker

Question Title

* Name

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* Stakeholder Role (please check all that apply)

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* Grade level. Please indicate the grade level of your child or children in the 2021-2022 school year. Please check all that apply:

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* School Corporation. Please select the name of your school cooperation from list below.

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* If your school corporation (or school) was not included on the list, please enter it here:

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* Email