Needs Survey IntroductionHello Arkansas Fathers!In order for us to stay in touch with you and to identify your needs, please complete all items in this 5 minute survey by March 10, 2023. We want to be better able to assist yo with your needs and connect you to the needed services. https://www.surveymonkey.com/r/FNNLPXDPart I: Basic Information Please complete the basic information below. Question Title * A. Name (Optional) Question Title * B. Please identify the type of early childhood program that serves your child/children: Arkansas Better Chance Head Start Early Head Start Faith-Based Home Visiting Other (please specify) Question Title * C. Which area of the state are you from? Northwest Northeast Central Southwest Southeast Question Title Question Title * D. How many children do you have and what are their ages? Question Title * F. Do you live in the home with your children? Yes No Part II: Basic Needs Question Title * A. Please check the boxes of the items you may need assistance with. a. Rent/Utility Assistance b. Food c. Employment d. Access to health care/medical insurance e. Transportation f. Child care g. Social Services (for your children) h. Housing i. Other (please specify) Question Title * B. Mental Health Support a. Anxiety/Depression b. Processing/Coping with Trauma c. General Counseling d. Dealing with Everyday Stress e. Opioid and Substance Misuse Question Title * C. Education a. Finishing High School/Getting your GED b. Going to College c. Grants/Scholarships d. Specialized Training/Vo-Tech e. Fatherhood Engagement Training Question Title * D. Parenting a. Education/Parenting Classes b. Activities to do with your children c. Meeting other fathers and families with young children d. Co-Parenting/Single Parenting e. Engaging in your child's education f. Balancing work and parenting Part III: Statewide Fatherhood Participation Question Title * A. Please check the boxes below for all Fatherhood Activities that you have participated in. (Check all that apply.) a. Fatherhood Statewide Training b. Dads Reading on the Carpet c. High Five for Dads d. Fatherhood Mentoring Program e. Powerful Conversations with Fathers f. Powerful Interactions with Fathers-Dragons Love Tacos g. Little Readers Rock h. March Madness i. Fatherhood Conference Tracks j. Fatherhood Virtual Pajama Party k. Reading is Electric with Fathers B. We are in the process of interviewing fathers for our website. If you wish to participate and share your "fatherhood story", please contact Hayse Miller @ 501-372-4242/hmiller@fsainc.org or Jackie Govan @ 501-371-0740/jackie.govan@arheadstart.org. Part IV: Fatherhood Resources and Brochure Distribution Question Title * A. We have the following resources available, please check all that you are familiar with: Fatherhood Research Data Fatherhood Brochures Online and National State Resources Fatherhood Pictograms Fatherhood Mission/Vision Question Title * B. If you would like more information on any of the resources below, please check the boxes below and put your email and phone number below: Fatherhood Brochure Fatherhood Mission/Vision Statement Online Resources List of Upcoming Events and Activities Other (please specify) Question Title * Email Question Title * Phone Number Question Title * Part V: Other AreasA. Please identify other needs or areas that you would be interested in hearing more about. Question Title * B. Please list any questions or comments that you may have regarding our fatherhood program. HSSCO-J. Govan Question Title Done
