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Thank you for your willingness to participate in this brief survey. Your survey responses will be completely confidential. The entire survey should only take 3-5 minutes to complete.

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* 1. I am the _________________ of a child(ren) who attend(s) middle school in the West Chester Area School District.

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* 2. My race/ethnicity is [check all that apply]:

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* 3. I am the parent or guardian of _____________ who attends middle school.

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* 4. My child(ren) currently attend(s):

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* 5. Please indicate the current grade(s) of each of your middle school-aged children (as of June 1, 2012). (Check all that apply.)

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