Where did you go to school and complete the education mentioned above? What is the main reason for leaving school when you did? _______________________________
2. How did you learn about the family literacy program?
3. Information about Child to be Enrolled Full Name of Child: ___________________________________________________________Child's Date of Birth: _______________ Gender: ![]() ![]() Is (Child's Name) enrolled in grade school now? ![]() ![]() Child's education before attending grade school: Information about Work and Family ActivitiesInterviewer Instructions: Please tell me about your work situation. (Read each category to the parent before asking for a response. Check one) 4. Work Situation ![]() ![]() ![]() How many hours a week do you work? _____ How long does it take you to go to/from work (one way) each day? Hours_____ Minutes_____ |
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