Survey Name * First Name Last Name Email * 1. What age is the child(ren) you are needing care for? * Grades K-1 Grades 2-3 Grades 4-5 Middle School - Comments (age of children) 2. How many hours per week (M-F) would you need childcare? * 3. What hours of care would be most beneficial to your schedule? * Mornings Afternoons - Comments (hours of care) 4. What education system is your child participating in? * Homeschool Public school Private school - Comments (education system) 5. What resources would you like to see made available in an afterschool program? * Tutoring STEM / STEAM Mentorship Community service All of the above - Comments (resources) 6. What is your current childcare cost per week? 7. What is the maximum range you are willing to invest in for an educational after school program? * 8. Any other comments / questions? Thank you!