Arcitec Parental Questionnaire

Arcitec Parental Questionnaire

Welcome to the Arcitec Foundation Parental Questionnaire. Your responses will play a crucial role in helping us gain insight into the needs, aspirations, and challenges our youth face. Your answers will be kept confidential and are instrumental in enhancing our programs and services.
Email Validator*
Name*

First NameLast Name
Email*
example@example.com
City & State of Residence*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Your Child's Age*
Age Range 11-18
What race/ethnicity best describes your child?*

Black / African AmericanWhite / CaucasianAmerican Indian / Alaskan NativeHispanic / LatinoAsian / Pacific IslanderBiracialOther
What's your martial status
Questionnaire Starts Below:

Thank you very much for taking this survey. Please answer all the questions as honestly as you can, and to the best of your ability. Remember that there are no right or wrong answers.
I feel safe in my neighborhood/community.*

TrueFalse
My neighborhood/community is safe enough for my child to walk around or navigate.*

TrueFalse
Does your child have a sense of belonging and connection to their community.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
What's the highest level of education you have?

How satisfied are you with the following services offered by the school?*

	Very dissatisfied	Dissatisfied	Satisfied	Very satisfied	Don't know
Academic Counseling
Communication
Student Safety
Academic Support

How capable do you think you are to support your child’s learning at home?*

Extremely capableSomewhat capableI struggle to help supportI cannot help support
Your child has access to educational resources outside of school (ie. Tutoring, educational apps).*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
Mentorship programs are readily available to youth in my community.*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
Does your child have access to mentors or adults who can help guide them (not counting a parent, guardian)?*

YesNoNot sure
Has your teen lost motivation, seen a drop in grades, been truant or suspended from school?*

YesNo
If you answered 'Yes' please share below the reasons why, if you feel comfortable doing so.
Optional
How does your child communicate with friends?*

While playing video gamesBy talking on the phoneBy text or social mediaIn person or FaceTimeAll of the above
Does your teen associate with a harmful or negative peer group (in your opinion)?*

YesNoNot sure
Does your child know how to handle stress, anxiety, or being uncomfortable in a healthy way?*

1

2

3

4

5

1 is Strongly disagree, 5 is Strongly agree
Is your teen struggling with self-esteem and self-worth?*

YesNoNot sure
Does your child know how to set and work towards their goals?*

1

2

3

4

5

1 is Needs help, 5 is Doesn't need help
Does your child know how to manage their time effectively.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
Does your child currently understand how to manage money .*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
Is it difficult for you to get your teen to do simple household chores (or homework)?*

TrueFalse
Do you think your child would feel confident giving a speech in front of a group of 20 people or more.*

Not confident at allA little confidentConfidentVery confident
Are you aware of different (non-sport) career opportunities available to your child?*

1

2

3

4

5

1 is Lack awareness, 5 is Fully aware
I think sports and physical activities are important for health and well-being.*

Strongly disagreeDisagreeNeutralAgreeStrongly agree
Does your child have interest in going to college/trade school?*

YesNoNot sure
Are you aware of scholarships and grants available for minorities to attend college?*

YesNoMaybe

What's you child's experience with the devices below?

	Doesn't Have it	Doesn't Use Much	Has Balance	Addicted	Beyond Addicted
Phones
Social Media
Video Games
Television

Is there anything else you'd like to share with us? Any specific challenges you face or support you'd like to receive from the Arcitec Foundation?
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Thank you for taking the time to complete this assessment. Your input is invaluable to us. Together, we can make a difference. Click 'Submit' in the box below to finish.
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Arcitec Parental Questionnaire

Questionnaire Starts Below:

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