Lesson 3: Beginning of the Year Survey

Standards:

Grade Level: K-6

Preparation: 20 minutes
Implementation: 20 minutes

National Standards for Family-School Partnerships

http://www.pta.org/nationalstandards

Standard 2:

Communicating effectivelyFamilies and school staff engages in regular, two-way,

meaningful communication about student learning.

Materials:
White or colored copy paper
English/Spanish survey
Copy machine or printer

Objective:
The teacher will collect data on students and families to have a better understanding of
students as individuals. The survey will provide communication preferences.

Procedure:

In the first week of school, determine how many families prefer English or
Spanish communication.
Asking students what their families prefer for communication is a quick way to
determine English/Spanish home language.
Before weekly communication folders go home, copy or print the surveys front to
back (colored paper is helpful in grabbing attention of parents).
Place the appropriate language copy in the students weekly communication
folder to take home.
Explain to the class that the survey is important because it helps the teacher to
communicate with their families.
Model how this survey should be completed and returned to the classroom
teacher.
Once returned, place the surveys in a secure binder or in a file cabinet where
student data is kept. Use the surveys for special occasions or when making
contact with parents.

Target Parent Engagement Interactions:

Communicating effectively

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Assessment:
Maintain surveys in an organized secure binder/filing cabinet. These could be scanned
into the computer as well.
Maintain a record of surveys returned and continue to advocate for their return. The
parent survey tracking log is provided to keep track of surveys returned. This survey
and tracking log can be maintained in a Class Data Binder or electronically.

Differentiation:

English and Spanish communication with parents.

Ability to use in person at a school event , such as back to school night, or in twoway communication sent home and returned with students.
This resource is hosted online for customization to best benefit the class and
teacher needs. bilingualfamilyengagement.weebly.com.

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Beginning of the Year Survey

Please fill out and return this survey to help me learn more about your family!

Childs name: ______________________________________ Birthday: ___________________

1. What are some areas your child excels in?
________________________________________________________________________________________________
2. What are some areas in which you think I could best help your child?
________________________________________________________________________________________________
3. What are some goals you have for your child this school year? _______________________
_______________________________________________________________________________________________
4. What is something unique about your family that you would like to share with me?
_______________________________________________________________________________________________
5. Does your child have any food allergies or medical needs that I should know about?
If so, please list. ____________________________________________________________________________
_______________________________________________________________________________________________
6. Please tell me some of your childs favorites:
Food: ________________________________

Sport: ______________________________

Color(s): _____________________________

Treat: _____________________________

Game: ________________________________

Activity: _____________________________

TV Show: ____________________________

Movie: _______________________________

Books: _____________________________________________________________________________________
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7. Parent Contact Information: Please list parents by who should be contacted first and
second.
1. Parent or Guardian_______________________

2. Parent or Guardian_______________________

Home number: ______________________________

Home number: ______________________________

Work number: ______________________________

Work number: _______________________________

Cell Phone: __________________________________

Cell Phone: __________________________________

Email address: ______________________________

Email address: _______________________________

________________________________________________

________________________________________________

May I contact you at work?

May I contact you at work?

Yes

No

Yes

No

8. Are there any important experiences that may be affecting your child? (Changed
schools, their best friend just moved away, death in the family, etc.)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
9. Please tell me about your family (family members, pets, favorite things to do,
culture, etc.).
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Parent signature(s): ___________________________________________

Date:________________________

___________________________________________

________________________

Thank You!
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Cuestionario del inicio del ao escolar

Por favor completa y regresa este cuestionario as puedo aprender ms de su familia!

Nombre del hijo/a: _______________________________________

Fecha de nacimiento: _________________________________
1. Cules son las reas de especializacin de su hijo/a?
________________________________________________________________________________________________
2. Cules son las reas que piensa que yo podra ayudar?
________________________________________________________________________________________________
3. Cules son las metas que su y su hijo/a tienen para este ao escolar?
_______________________________________________________________________________________________
4. Hay algo especial que quiere compartir conmigo?
_______________________________________________________________________________________________
5. Si su hijo/a tiene alergias o necesidades mdicas por favor describa aqu.
_______________________________________________________________________________________________
6. Por favor hbleme de algunas cosas favoritas de su hijo/a:
Comida: ________________________________

Deportivo: ______________________________

Color(es): _____________________________

Merienda: _____________________________

Juego: ________________________________

Actividad: _____________________________

Programa de TV: __________________________

Pelcula: _______________________________

Libros: _____________________________________________________________________________________
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7. Informacin de los padres. Por favor lista los padres/personas que deberan ser
contactados y en cual orden.
1. Padre/Guardin _______________________

2. Padre/Guardin _______________________

Nmero de Telfono de casa:

__________________________________

Nmero de Telfono de casa:

__________________________________

Nmero de trabajo:
__________________________________

Nmero de trabajo:
___________________________________

Nmero de Celular:
__________________________________

Nmero de Celular:
____________________________________

Correo electrnico:
________________________________________

Correo electrnico:
________________________________________

Puedo contactarlo al trabajo?

s
No

Puedo contactarlo al trabajo?

s
No

8. Hay situaciones especiales que yo debera saber? (Su mejor amigo pasa a un nuevo
lugar, muerte en la familia, u otra situacin.)
________________________________________________________________________________________________
________________________________________________________________________________________________
________________________________________________________________________________________________
9. Por favor dgame sobre su familia (miembros de familia, mascotas, lo que le gusta
hacer, cultura, etc.).
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Firma de Padre(s): ___________________________________________

Fecha:________________________

Gracias!
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Student Name:

Parent Survey Tracking Log

Survey Returned
(Checkmark if returned)

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