Special Needs Electives Survey Form
Help us improve elective offerings for students with special needs by sharing your preferences and feedback.
Your Full Name
*
First Name
Last Name
Your Relationship to the Student
*
Parent/Guardian
Student
Teacher/Staff
Other
Email Address
*
example@example.com
Student's Grade Level
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
High School
Other
Type of Special Need(s)
*
Learning Disability
Autism Spectrum Disorder
ADHD
Physical Disability
Sensory Impairment (Vision/Hearing)
Speech/Language Impairment
Emotional/Behavioral Disorder
Other
Which electives are you most interested in for the student? (Select all that apply)
*
Art
Music
Physical Education
Technology/Computers
Drama/Theater
Foreign Language
Cooking/Life Skills
Other
Please rate the accessibility and inclusiveness of the current elective offerings for students with special needs.
*
Rows
Accessibility
Inclusiveness
Art
1
2
Music
3
4
Physical Education
5
6
Technology/Computers
7
8
Drama/Theater
9
10
Foreign Language
11
12
Cooking/Life Skills
13
14
What accommodations or supports does the student currently receive for electives?
Paraprofessional support
Modified curriculum
Assistive technology
Sensory supports
Preferential seating
Other
Are there any barriers or challenges that make it difficult for the student to participate in electives?
*
Yes
No
If yes, please describe the barriers or challenges.
How satisfied are you with the current elective options for students with special needs?
*
1
2
3
4
5
What additional electives or supports would you like to see offered?
Additional comments or suggestions to improve elective experiences for students with special needs:
Submit Survey
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