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Beginning of the Year Family Survey

General Information

Student name: Parent(s) name:

Current address/telephone number:

What is students country of origin? What is students native language?

How long has the child been in the United States? Who lives with the child in the home?

What brought your family to the United States?

Parent Interview

Tell me about/describe your child.

What are your childs strengths/interests?

How does your child feel about school? How does he/she feel about himself/herself?

What concerns do you have about your child (academic, social-emotional, health, etc.)?

Talk about your childs past academic experiences. How was your childs previous grades/schools? Did you
have any concerns? How did you like your childs experience in previous grades/schools?

What is a typical day/schedule at home look like for your student/family?

Who helps your student at home with his/her studies?

Does your child have any responsibilities or chores at home?

What does your family believe in regards to discipline?

What holidays does your family celebrate?

Where do you see your student in 5 years, 10 years?

What are your goals for your student? What would you like to see happen for him/her this year?

Does your family need any help/resources that the school can connect you with?

Is there anything else you would like to share that will help me get to know your child and family better?