Survey For PEP Course Before you took the PEP course, did you know that it is critical to give your child at least 10 minutes of individual time every day? Individual time means you are interacting directly with your child, like playing with them or reading a book with them. Yes No Has the PEP course influenced in your decision to spend individual time with your child daily? Yes, I want to begin spending at least 10 minutes of individual time with my child Yes, I want to add more time to what I was already spending with my child. No, I am already spending at least 10 minutes of individual time with my child daily. No, the course did not impact me in this area. Before you took the PEP course, did you know the importance of telling your child “I love you” every day? Yes No Has the PEP course influenced in your decision to tell your child “I love you”? Yes, I want to begin telling my child “I love you”. Yes, I say “I love you” to my child, but now I want to do it every day. No, I was already telling my child “I love you” every day. No, the course did not impact me in this area. Before you took the PEP course, did you know that maintaining eye contact when talking with your child will improve communication and show him/her that they are valued? Yes No Has the PEP course influenced in your decision to maintain eye contact when talking with your child? Yes, I want to begin maintaining eye contact when talking with my child. Yes, I was already making eye contact but now I want to intentionally maintain it throughout our conversation. No, I was already maintaining contact when talking with my child. No, the course did not impact me in this area. Before you took the PEP course, did you know that listening to your child’s side of the story is important in establishing trust? Yes No Has the PEP course influenced in your decision to encourage your child’s efforts? Yes, I want to begin listening to my child’s side of the story. No, I was already listening to my child’s side of the story. No, the course did not impact me in this area. Before you took the PEP course, did you know about the importance of encouraging your child’s efforts. Yes No Has the PEP course influenced in your decision to encourage your child’s efforts? Yes, I want to begin encouraging my child’s efforts. Yes, I was already encouraging my child’s efforts but now I want to encourage them even more than before. No, I was already encouraging my child’s efforts enough. No, the course did not impact me in this area. Before you took the PEP course, did you know investing your time in your child’s learning has a great impact on their success at school? Examples of investing your time would be reading to your small child, encouraging your child to read and do their homework, keeping up with their grades, attending school meetings, etc. Yes No Has the PEP course influenced in your decision to invest your time in your child’s learning? Yes, I want to begin investing my time in my child’s learning. Yes, I want to invest even more time than before in my child’s learning. No, I was already investing enough of my time in my child’s learning No, the course did not impact me in this area. First Name: ***This is what will be printed on your certificate. Make sure it is correct!***Last Name: ***Please enter a valid email address that you can access. This is important as this is where your certificate for completing the course will be sent. ***Email: ***This is what will be printed on your certificate. Make sure it is correct!***Gender: Male Female Prefer Not To Say Age: Ethnicity: African American Asian Hispanic White Role: Parent Grandparent Guardian Zip Code: Highest level of education completed: Elementary School Middle School High School Associate Degree College Degree Master’s Degree or Higher How many children are in your care? What are the ages of the children? 0-10 11-13 14-18 18+ Δ
