DRAFT Form 4-7
Form 4-7
CHILD & FAMILY DEVELOPMENT PROGRAMS
Community Action Team
Family Interest Survey
Parents are important in Head Start. To best support parents in meeting individual needs, Head Start needs your input for planning monthly center activities/trainings/meetings.
Please check the areas that you are interested in knowing more about.
|√ |PARENTING EDUCATION SERIES |√ |MENTAL HEALTH/YOU |
| |Make Parenting a Pleasure | |Anger Management |
| |Parenting Now | |Stress Management |
| |Birth to Three | |Adult Children of Alcoholic’s |
| |Second Step Family Training | |Alcohol & Drug Information |
| |Every Child Ready to Read | |Addictions – How to Cope |
| |All for Math | |Building Healthy Families |
|√ |PARENTING WORKSHOPS | |Counseling Options |
| |Involving Fathers/Men in Child’s Life | |Dealing with Depression |
| |Single Parenting | |Personal Safety/Self Defense |
| |Step Parenting | |Taking Care of You |
| |Child Development | |Other: |
| |Behavior Management with Children |√ |LEGAL |
| |Children’s Self-Esteem | |Legal Aid |
| |Reading Readiness | |Landlord – Tenant |
| |Darkness to Light – Protecting Children from Sexual abuse | |Restraining Orders |
| |Foster Parenting | |Support Enforcement |
| |Raising Grandchildren | |Child Abuse & Neglect |
|√ |HEALTH/DENTAL | |Birth Certificates |
| |Childhood Emergencies | |Expunging Criminal Record |
| |Dental Care, Fluoride & Emergencies | |Other: |
| |Raising Your Child in Safe Environments |√ |ADULT EDUCATION |
| |First Aid/CPR | |GED Classes / High School Completion |
| |Accessing Medical/Dental Services | |Back to School as an Adult / FAFSA |
| |Getting the Most out of a Medical/Dental Appointment | |Center Training Assistant (CTA)- Job Training Opportunity at Head Start |
| |Communicable Diseases | |Introduction to Computers |
| |Quit Smoking/Quit Chewing | |Head Start & Other Scholarships |
| |2nd or 3rd Hand Tobacco Smoke | |ELL/ESL Classes |
| |Adult Health Issues | |Other: |
| |Other: | | |
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|√ |NUTRITION |√ |THE COMMUNITY |
| |Healthy Snacks Kids Love | |Local Resources / Activities Available to Me and My Family |
| |Low Budget Cooking | |Entering Kindergarten/Working with Local Public Schools |
| |Using a Budget to Shop | |Selecting Quality Child Care |
| |Other: | |Driver License |
|√ |SPENDING AND SAVING | |Other: |
| |Credit (repair, improve, free reports, etc.) |√ |FUN |
| |Bank Accounts | |Fitness |
| |College Saving Plans | |Music / Dance |
| |Borrowing Basics | |Coffee Clutch |
| |Smart Spending Plans | |Making Crafts for Fun |
| |Making Your Money Grow | |Family Time |
| |Loan to Own | |How to Cut Your Child’s Hair |
| |Other: | |Family Reading Time / Reading to Children |
| | | |Other: |
List your special hobbies, skills or interests you might like to share with other Head Start parents or share with the children in the classroom.
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Parent Signature Date
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