Lesson 3 Parent Survey Lesson-Eng-Span
Lesson 3 Parent Survey Lesson-Eng-Span
Lesson 3 Parent Survey Lesson-Eng-Span
Standards:
Standard 2:
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.
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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:
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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_______________________
________________________________________________
________________________________________________
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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Deportivo: ______________________________
Color(es): _____________________________
Merienda: _____________________________
Juego: ________________________________
Actividad: _____________________________
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 trabajo:
__________________________________
Nmero de trabajo:
___________________________________
Nmero de Celular:
__________________________________
Nmero de Celular:
____________________________________
Correo electrnico:
________________________________________
Correo electrnico:
________________________________________
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:
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