Education Demographics
A short survey form for student's parents/guardian
Parents Name
First Name
Last Name
Child Name
First Name
Last Name
What grade is your child in?
Please Select
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Which race/ethnicity best describes your child?
American Indian
Asian
Black or African American
Hispanic American
White / Caucasian
Other
What is your relationship to your child?
Mother
Father
Step-mother
Step-father
Grandmother
Grandfather
Guardian
Other
Please describe your relationship to your child
What is your primary language?
Chinese
English
French
German
Italian
Korean
Russian
Spanish
Tagalog
Vietnamese
Other
What is your approximate average household income?
$0 - $20,000
$21,000 - $40,000
$41,000 - $60,000
$61,000 - $80,000
$101,000 - $120,000
$121,000 +
Submit
Should be Empty: