Caretaker Questionnaire

Caretaker(s) (parent(s)/guardian(s)/etc.): please fill out all of the following data and click the "Submit" button when you are finished. Each parent is welcome to fill out a separate questionnaire, if desired.

The goal of this survey is to help me get a sense of your expectations for your child in physics class. This information will be valuable in helping me to meet your child's needs, as well as your own needs as a caretaker.

This questionnaire should take you about 10–15 minutes. Please answer the questions honestly; I do not believe that there are any "good" or "bad" answers. For example, if you rarely check in with your child about homework, it might be because you have never needed to do so.

The fields that have a blue asterisk (*) are required. If you leave any of these blank, you will get an error when you try to submit the page.

Your name (caretaker): *

Student's name: * (include last name(s) if different)

Please fill in your contact information below.

Are you comfortable talking with me in English?*      Yes      No. I would need someone to translate.

If I need to contact you, would you prefer that I call  or   email?

How often do you talk about regular, day-to-day homework assignments with your child?*
never      sometimes      often      always

How often do you talk about tests and major assignments with your child?*
never      sometimes      often      always

How often do you talk with your child about their activities, interests and other things happening in their life?*
rarely or never      sometimes      often      pretty much every day

Physics involves a significant amount of math and problem-solving. Previous science and math grades are often a good prediction of how well a student will do in physics. (Don't worry if you don't remember your child's exact grades. A best guess is fine.)

What is something about your child that you are proud of?

What is one thing that you would you like to see your child get out of school this year?

What do you think your child will do after graduating from high school?

Is there anything about your child (such as past academic performance, learning style, personality, etc.) that you think a teacher would want to be aware of?

Would you like an opportunity to discuss the upcoming school year with me? (Please check as many as apply.)