Download parent questionnaire

CULTURAL LIAISON,
In order to complete the June online Impact Survey, you will
need information about your families’ Family Pass usage. This
questionnaire is an optional tool you can distribute to your
families. Please do not return this form to Cool Culture.
PARENT QUESTIONNAIRE
Complete AFTER JUN 1st
To Parent/Guardian (Name):___________________________________________
Return to Staff (Name): _____________________________________________________
Return Location: ___________________________________________________________
Please Return By: __________________________________________________________
Please answer the questions below. Cool Culture will use your answers to make
their programs better. Thank you for sharing!
1) Did you receive your Cool Culture Family Pass?
____ Yes
____ No
2) From November 2012 - June 1, 2013 (past 7 months),
(Choose only one answer)
_______
My family did NOT use our Cool Culture Family Pass yet, but we will soon
_______
My family used the Cool Culture Family Pass 1 time
_______
My family used the Cool Culture Family Pass 2 or more times
3) What motivates you to use your Cool Culture Family Pass? (Optional)
CULTURAL LIAISON,
In order to complete the June online Impact Survey, you will
need information about your families’ Family Pass usage. This
questionnaire is an optional tool you can distribute to your
families. Please do not return this form to Cool Culture.
Cuestionario Para Padres
Llene DESPUÉS del 1 de junio
Al Padre (Nombre): ___________________________________________________
Devuelva a (Nombre): _____________________________________________________
Fecha y Lugar de Entrega: __________________________________________________
Por favor conteste estas cortas preguntas. Cool Culture utilizará sus respuestas para
mejorar sus programas. Gracias por compartir!
1) ¿Recibió su Pase Familiar Cool Culture?
____ Sí
____ No
2) Desde noviembre de 2012 hasta el 1 de junio de 2013 (pasados 7 meses):
(Elija UNA respuesta)
____ Mi familia aún NO ha utilizado el Pase Familiar Cool Culture pero pronto lo
hará
____ Mi familia utilizó el Pase Familiar Cool Culture 1 vez
____ Mi familia utilizó el Pase Familiar Cool Culture 2 veces o más
3) Cual es su motivación en usar su Pase Familiar Cool Culture? (opcional)
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
CULTURAL LIAISON,
In order to complete the June online Impact Survey, you will
need information about your families’ Family Pass usage. This
questionnaire is an optional tool you can distribute to your
families. Please do not return this form to Cool Culture.
家長問卷
（於2013年6月1日後填寫）
給家長 (姓名):_________________________________________________________
繳回給學校職員 (姓名): ______________________________________________________
繳回日期和地點: ____________________________________________________________
請回答以下問題。 您的意見將幫助酷文化改善我們的服務。 感謝您的分享!
1) 請問你有沒有收到你的酷文化家庭通行證?
______ 有
_____ 沒有
2) 從 2012 年 11 月起到 2013 年 6 月 1 日止:
(請勾選一個答案)
_______
我和家人沒有使用過酷文化通行證，但我們很快就會使用
_____
我和家人使用過酷文化通行證一次
__________
我和家人使用過酷文化通行證二次以上
3) 當你和家人使用酷文化通行證的時候，你希望你的孩子能夠從參觀博物館中獲得什麼?
(選答)