GEAR UP: Parent Questionnaire 2013-14

(please fill in box or circle the letter for each answer)

First Name / Last Name / (area code) / Phone
Parent/Guardian Name
Address / City / Zip
Parent/Guardian Address

Information about your childin9th or 10th gradeduring 2013-14 (use a separate form for each child):

First / Name / Middle Name / Last Name
Student Name
CPS Student ID # / Birth Month / Birth Date / Birth Year / School / Grade

1. Have you participated in any GEAR UP activities (likebook clubs, college tours,

computer classes, financial aid or other workshops, etc.)? A) yes B) no

2. Has anyone from your child’s school or GEAR UP ever spoken with you about

college entrance requirements? A) yes B) no

3. Has anyone from your child’s school or GEAR UP ever spoken with you about

the availability of financial aid to help you pay for college? A) yes B) no

4. Are you knowledgeable about financial aid and the cost and benefits of your child pursuing a

postsecondary education? A) yes B) no

5. Do you know what courses your child needs to complete in order to graduate from high school? A) yes B) no

6. Have you talked with your child (children) about attending college? A) yes B) no

7. Do you know what courses your child needs to complete in order to be accepted into college? A) yes B) no

8. What is the highest level of education that you think your child will achieve? (Choose only one answer)

A) High school or less

B) Some college but less than a 4-year college degree

C) 4-year college degree or higher

9. What is the highest level of education of both parents? (Please mark one box for each parent)

High school
or less / Some college but
less than a 4-year college degree / 4-year college degree or higher / Unknown
Mother /  /  /  / 
Father /  /  /  / 

10. Do you think that your child could afford to attend a public 4-year college using financial aid,

scholarships,and your family’s resources? A) yes B) no

11. Do you have enough information about preparing for college? A) yes B) no

12. Would you like someone from GEAR UP to contact you about working together

to prepare your child(children) for college? A) yes B) no