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TH
GRADE STUDENT PARENTAL INVOLVEMENT SURVEY
(circle the best answer or fill in the blank)
Race/Ethnicity: Asian Black Hispanic/Latino Native American White Other?___________
Gender: _________________ Sexual Orientation __________________ Free/Reduced Lunch? Yes No
Grades in School: Mostly As Mostly Bs Mostly Cs Mostly Ds Most ly Fs
Parents Education: High School Drop Out High School Diploma 2 Year College Degree

Bachelors Degree Masters Degree Doctorate Degree
Do you live with one or both of your parents? One Both Other?__________________________
For each item shown below, circle the number
to the right that best fits your opinion.
Use the scale to select the most precise number.
Survey Item
Scale
N
e
v
e
r
Sometimes


O
f
t
e
n


1. How often do your parents visit your school? 1 2 3 4 5
2. How often do your parents get involved with school activities? 1 2 3 4 5
3. How often do your parents miss your school related events
(parent conferences, sporting events, etc.)?
1 2 3 4 5
4. How often do your parents keep up with your academic progress
at school (online grades, emailing teachers, etc.)?
1 2 3 4 5
5. How often do your parents talk with you about school? 1 2 3 4 5
6. How often do your parents get together with other parents to
discuss your school?
1 2 3 4 5
7. How often do your parents fail to check in with you about your
day-to-day happenings at school?
1 2 3 4 5
8. How often do you miss school because your parents were too
busy to get you there?
1 2 3 4 5
9. How often do your parents worry about school related activities
because of childcare?
1 2 3 4 5

(circle one)
Does one of your parents work two or more jobs? Yes No


Do your parent(s) believe you are getting a good education at your school? Yes No

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