First Name *

Last Name *

Email *

How many students do you have in a K-12 school?

What school do they attend?

What school does your first student attend?

What school does your second student attend?

Does your student currently participate in an afterschool program?

Yes

No

Did the school obtain your input on the afterschool program?

Yes

No

Unsure

What reason(s) does your child not attend an afterschool program?

What is the name of the afterschool program?

How satisfied are you with the afterschool program:

Additional comments or suggestions

Take the Afterschool Program Survey