Parent Survey – Expansion Breakfast Program
Many families today do not have time to eat a healthy breakfast before getting everyone out the door to school and work. To provide the children of our community with a reliable opportunity to enjoy a healthy breakfast every school day, we are exploring the possibilities for expanding the availability of our school’s breakfast program. However, we need your help to ensure that our program is able to best serve your child’s needs. Please take a few minutes to fill out this form and return it to us. Your input is extremely valuable.
1. Does your child have time to eat breakfast at home? YES / NO
If no, what are your child’s other options for eating breakfast?
______
2. Did you know that breakfast is offered at school? YES / NO
3. Does your child eat breakfast at school? YES / NO
If no, why not?
______
4. Does your child ride a bus to school? YES / NO
If yes, for how long? ______
5. Please list some of the foods your child eats for breakfast.
______
______
______
______
6. There are many ways to serve breakfast at school! We are considering multiple service delivery methods for our program. Please select the alternative that you or your child would most like to see in our school. [Include only if you are considering one or more alternative service models.]
q Breakfast service in Cafeteria after 1st period
q Bagged “Grab ‘n Go” breakfasts (served from carts throughout school)
q Breakfast in homeroom
q Breakfast on the bus (served on way to school)
7. If we implemented the service model you selected/described above, how much more likely would you be to encourage your child to participate in the School Breakfast Program?
1 2 3 4
Not at all Slightly more Somewhat Much more
More likely likely more likely likely
8. Would you purchase a school breakfast for your child if it cost less than $ _____? YES / NO
If no, why not?
______