Model Questionnaire for an After-School Club
Survey to determine the need for childcare.
1. Do you already use childcare?
q No (please move to question 2)
q Yes (please tick the types of childcare you use)
q Childminder / q Holiday playschemeq Breakfast club / q Friends and family
q After-school club / q Full daycare/nursery for children 0– 5
q Nanny / q Other (please describe)
Comment
2. Would more suitable local childcare help you to:
q Extend your working hours / q Return to, or start trainingq Return to or start work / q Other (please specify)
Comment
Please tell us about the childcare you need:
3. Breakfast club (approximate cost £5 - £6 per day depending on opening hours)
q I would not need a breakfast club (please move to question 4)
I would use a breakfast club on these days:
q Monday q Tuesday q Wednesday q Thursday q Friday q undecided as yet
Number of children who would attend ……………… Age(s) of child(ren) ………………………
I would need a breakfast club to be available: (please choose one option)
q 7.30am to the start of the school day q 8am to the start of the school day
Comments4. After-school club (approx cost £10 - £15 per day depending on opening hours)
q I do not need an after-school club (please move to question 4)
q I may need an after-school club but I would like to evaluate a new provision first and understand how it would work for me. I am therefore interested but not decided as yet.
q I need childcare and would use an after-school club on these days:
q Monday q Tuesday q Wednesday q Thursday q Friday q undecided as yet
Number of children who would attend ……………… Age(s) of child(ren) ………………………
I would need an after-school club to run from the end of school until: (please choose one option)
q 5.30pm q 6pm
Children may want to attend their existing school-based activities (football, choir, etc) and then go into the after-school club. Please note that the after school club will probably need to charge the full cost of the session when this happens to maintain necessary staffing levels.
Comments5. Holiday playscheme (approximate cost £25 per day, £14 half day)
q I would not need a holiday playscheme (please move to question 6)
I would use a holiday playscheme during these holidays:
q October holiday q Christmas holiday
q February holiday q April holiday
q Late Spring holiday (May) q Summer holiday
I would use a holiday playscheme, in all the holidays I have ticked, on these days:
q Monday q Tuesday q Wednesday q Thursday q Friday
Number of children who would attend ……………… Age(s) of child(ren) ………………………
I would need a holiday playscheme to be available: (please choose one option)
q 7.30am to 5.30pm q 7.30am to 6pm
q 8am to 5.30pm q 8am to 6pm
q Other (please specify)
Comments6. Would you consider changing any existing childcare arrangements if this new childcare was available?
q Yes q No q Not applicable
If yes, it would be helpful to know why …………………………………………………………….....
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7. Would you be interested in running / helping with / supporting a club/playscheme, if we opened one?
q Yes q No
If yes, please give your name below, so we can contact you
If ‘Yes’, in what capacity? For example, Supervisor / Playleader, Assistant,helping with administration, part of the management team.
8. Are you a registered childminder?
q Yes q No
9. Are you interested in becoming a registered childminder?
q Yes q No
If yes, please give your name below, so we can contact you
10. Have you any further comments?…………………………………….……………………
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Name ……………………………………………………………….……..…………………………….
Address ………………………………..…………………………….………………..………..……….
Telephone ……………………………. ………email address ………….……………………………
Please return this form by ……………. to …………………………………………………….
THANK YOU
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Updated April 2013.