District 16 Family Check In

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We want to know how you are doing and the best way to support you and your child(ren) during this time. Please take some time to fill out this quick survey. Thank you in advance for your help with this.

Email *

Name of Person Completing the Survey *

Phone Number Contact

What is the best way to reach you and your family?

By E-mail

By Phone

Either way works

Other:

What school(s) do the students in your household attend? *

16K005

16K021

16K025

16K026

16K028

16K035

16K040

16K057

16K081

16K243

16K262

16K267

16K308

16K309

16K335

16K627

16K628

16K681

16K688

16K898

Other:

Required

How are you and your family doing? Check all that apply. *

We are doing well.

We are doing okay. Thankful we are not sick.

We have sick family members, but we are doing okay.

We are not doing well at all physically, and would love some help.

We are not doing well at all emotionally, and would love some help.

Please call us. We would like to talk.

Required

We are struggling with....Check all that apply. *

Technology

Completing work from school

Communicating with teachers and school staff

Household necessities (i.e., food, paper products, personal hygiene items, etc.)

Staying organized

Childcare

We are going stir crazy! We need ideas on how to keep the kids occupied!

Other:

Required

I wish the school would... *

Anything else that you would like us to know about?

Submit

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