Required Information
Music Haven PARENT Program Evaluation 2017

To be filled out by PARENT or GUARDIAN
1.Parent/Guardian's First Name

2.Parent/Guardian's Last Name

3.Child's First Name
4.Child's Last Name
5.Child's Age

6.Child's School

7.The Neighborhood Child Lives In
8.Is your family income less than $50,000?
9.How many years has your child been in Music Haven?

10.How many hours per week did your child spend at Music Haven this past year (on average)?

Please answer the following questions with respect to your opinion and perception of Music Haven's after-school programs. These questions will help us develop our evaluation report on the effectiveness of our programs.

Please note that all responses are CONFIDENTIAL! Your name and your child's name will be removed from the survey data before responses are examined.We share this report with funders and various community stakeholders. We appreciate your open and honest responses.

For each question below, please select one answer that best describes your child right now:
11.My child is comfortable working in a group/team setting.
12.My child is good at planning ahead.
13.My child feels like he or she is a part of our community.
14.My child is comfortable connecting to and working with adults.
15.My child notices when other people are having a hard time.
16.When facing difficult tasks, my child is confident he/she will accomplish them.
17.My child thinks about choices before making a decision.
18.My child believes he/she can succeed at most any goal he/she sets.
19.My child is motivated to work harder at things he or she wants to accomplish.
20.My child is patient when learning new things.
21.It's easy for my child to talk to new people.
22.My child's musical skills have improved over the year.
23.When something is hard, my child tends to give up.
24.My child believes he/she will be able to successfully overcome many challenges.
25.Playing music helps my child to calm down when he/she is stressed out.
26.Even when things are tough, my child can perform very well.
27.My child believes that he/she can make our community better by playing music.
28.We often get to spend quality time as a family.
29.Music Haven teachers are good role models for my child.
30.What changes, if any, have you noticed in your child as a result of his or her involvement with Music Haven?

31.How has being involved with Music Haven affected your family's life this past year? Please note any effect Music Haven has had on parents, siblings, or extended family.

32.What Music Haven programs was your child involved in this past year?  (Please check all that apply)
33.Which of the following events did you attend this year? (check all that apply)
34.Are any of the following obstacles to your family's full participation in Music Haven?
35.Please tell us your suggestions for ways to improve Music Haven.

As a security measure, your survey timeout is set to 60 minutes of inactivity. If you leave this survey inactive for this duration, all your previous answers may be lost.