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Free After School Needs Assessment Form Template

Free After School Needs Assessment Form

Name: Free After School Needs Assessment Form Template
Brand: Template.net
Availability: InStock

After School Needs Assessment Form

Please complete this form to evaluate and identify the needs, interests, and preferences of students and families for after-school programs.

Name

Phone number

Email

Please mark the type of After School care you are currently utilizing.

Day Care Center
Family Care Center
Provider in my home
Spouse/Partner
Care by family members
After School Program
Care by older sibling
Not utilizing any After School care

Which one prevents you from utilizing the service?

Availability
Location
Hours of Operation
Happy with current provider
Transportation

Please indicate your household gross salary

Less than $20,000
$20,000 - $29,000
$30,000 - $ 39,000
$40,000 - $ 49,000
$50,000 - $59,000
More than $60,000

Number of People in your household

List All the People in Your Household

Role

Child
Adult
Elder

Age

Date of Birth

Need Childcare?

Which Days if Childcare needed

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

When Childcare needed

Before School
After School

Approximately what time does an adult get home after school hours?

What would be the amount you consider reasonable to pay for school-age child care per month/per child?

What childcare-related problems have you faced during the past year?

Cost of Care
Finding Temporary Care
Finding Care for a child with special needs
Location of care
Transportation to/from care
Dependability of care
No issues

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Evaluate student needs effectively with our After School Needs Assessment Form Template from Template.net. This customizable and editable form allows you to assess the specific requirements of after-school programs, ensuring proper support for students. Easily tailor the form with our user-friendly AI Editor Tool. Download today to streamline your assessment process and enhance student development!