nIc Foundation-Parent Survey

Needs Assessment Inventory for Families

nIc Foundation, Inc.

Data Gathering

Parent Survey

Please give us your input!

Your E-mail Address: *

Can you name someone who is a person of good character? *	Yes No
Do you think that modeling and nurturing good character in the home is important in raising children who will be loving, respectful, and compassionate? *	Yes No
Have you or someone you know been a victim of any kind of violence? *	Yes No
Does your school help your child build the positive character traits that will discourage violent behaviors in later years? *	Yes No
Does your child participate in community organizations / activities such as scouting, church, music, dance and sports either after school or on the weekends? *	Yes No
Is your family able to schedule and participate in weekly family activities that encourage all of you to spend quality time doing “things” together? *	Yes No
What kind of resources would you like to receive to help you build positive character traits at home? (check boxes)
ideas to raise children of good character information on child development ways to help your child succeed in school recommendations of quality children’s literature books statistical information about violence in America monitoring computer access involving teenagers in family time activities other
Do you have any ideas on how our schools could provide the community service learning component in your child’s education? Please state your ideas:

What tip do you have for raising children of “good character?”

Name *

Address *

City *

State *

Zip *

Phone

Additional comments:



* Required