Colonial Heights School System SURVEY

Please copy this file and cut & paste it into your word processor.  Complete the form.  Mail or email it using the instructions at the bottom of the page.  Thank you for taking the time to let me know how you feel about how we can make Colonial Heights Schools better.

1.  Are you a resident of Colonial Heights?  ___ YES   ___ NO

2.  Name and Address (optional): Name: _______________________________________________

                                     Street Address: _______________________________________________

                                                              _______________________________________________

3.  Are you a :    ___ Parent     ___ Grandparent     ___ Guardian      ___ Student      ___ Other

4.  Date of this survey: ____________________

5.  What are your top five areas of concerns regarding public education in the Colonial Heights City School system?

    ____  A.

    ____  B.

    ____  C.

    ____  D.

    ____  E.

6.  On a scale of 1-5, with 1 being the greatest concern, identify the priority of the topics listed in item 5.

7.  What would you recommend as a solution to your top three concerns?

Concern #1 Solution:

Concern #2 Solution:

Concern #3 Solution:

8.  Any other comments, suggestions, or solutions you would like to offer (use the back of this page or additional paper if desired).

Thank you for providing your concerns and comments regarding Colonial Heights Public Schools. You may mail your response to: School Board Member Joe Green, 514 Walnut Ave., Colonial Heights VA 23834 or email it to me at wjoegreen@yahoo.com.