Parent Questionnaire (Page 5 of 5) in pdf

Parent Questionnaire -- Grades 5-6

CHILD'S NAME ________________________________________

Grade Level: ____________

Part 1. Background

1.1

Your relationship to child enrolled in school: Mother_____

Father_____

Other_____

1.2

What is your and your spouse's ethnic background?

You

Your spouse

You

Your spouse

___ ___ Hispanic/Latino

___ ___ Asian-American

___ ___ Caucasian/Anglo

___ ___ American Indian/Alaskan Native

___ ___ African-American

1.3

What is the highest level of education that you and your spouse have completed?

You

Your spouse

You

Your spouse

___ ___ Elementary

___ ___ Community College/Vocational School

___ ___ Junior High/Middle School

___ ___ 4-year College/University Degree

___ ___ High School or equivalent

___ ___ Professional Degree/Graduate School

1.4

What language(s) do you and your spouse speak? You:_________________ Your Spouse:__________________

1.5

Please check below your own and your spouse's ability to communicate in Spanish.

You

Your spouse

___ ___ No ability; cannot understand or speak the language at all.

___ ___ Can understand somewhat but cannot speak the language.

___ ___ Can understand and speak the language somewhat.

___ ___ Can understand and speak the language very well.

___ ___ Native speaker, or native-like ability in the language.

Part 2. Please indicate how strongly you agree or disagree with the following statements. (CIRCLE ONE ANSWER FOR EACH

STATEMENT.)

Strongly

Not

Strongly

Disagree Disagree Sure

Agree

2.1

In my family, we assume that my child will go to college.

I understand how to help prepare my child for college.

a little confused about how to help our child think about and

prepare for college.

not sure how to make sure our child gets the right classes in

middle school to get him/her on the right track to college.

2.5

I would like more information about how to help my child get ready for college. 1

2.6

I do not think that my child needs or wants to attend college.

2.7

I am aware of the different colleges/universities in our area.

Parent Questionnaire Page 5

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