Administrator Survey – WITH Breakfast Program

(to be filled out once parent/student surveys are returned and then sent to your State Agency)

  1. Record your enrollment here: ______
  1. How many students took the survey? ______
  1. Of the students who took the survey, how many recognized the importance of eating breakfast? ______
  1. How many had breakfast at home that included at least one of these components?

_____ Milk/Soy Milk_____ Juice/Fruit/Vegetable

_____ Meat/Cheese/Yogurt/Beans_____ Cereal/Bread/Muffin/Bagel

Egg/FishRice/Tortilla

  1. How many had breakfast at school? ______
  1. How many students bought foods from store/fast food restaurant/vending machines for breakfast? ______
  1. How many students spend more than 30 minutes getting to school? ______
  1. Of those students not getting to school early enough to eat breakfast, how many are riding the bus? ______
  1. How many students arrive at school at least 20 minutes prior to school starting? ______
  1. How many students participate in before-school activities? ______
  1. Are you able to add any of the foods the students indicated they liked to your breakfast menu? YES/NO

If yes, which foods?

______

______

If no, why not?

______

  1. How many students said they would participate in the School Breakfast Program if more food choices were offered? ______
  1. What were the primary reasons students gave for why they do not/would not eat school breakfast?

______

______

  1. How many parents took the survey? ______
  1. How many said their children did not have time to eat breakfast at home? ______
  1. How many parents were aware of breakfast as an option at school? ______
  1. How many parents reported their children ate breakfast at school? ______
  1. What were the primary reasons parents gave that their children did not eat breakfast at school?

______

______

  1. How many parents reported their children ride the bus to school? ______
  1. What was the minimum/maximum length of time children spent on the bus?

Minimum ______Maximum ______

  1. Are there foods parents listed that could be added to your school breakfast menu? YES/NO

If yes, what foods?

______

______

If no, why not?

______

  1. What did these answers reveal to you about ways you can make your school breakfast program more appealing to students and parents?

______

______

23. Based on this assessment, your State Agency can help you develop new ways to expand

your School Breakfast Program.

What is the best way to contact you?

______

Who is the lead for your school on food programs?

Contact Lead: ______Contact Information: ______

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