It is the mission of the Northland Early Childhood Collaborative to have all children ready to learn as they enter Kindergarten and be successful learners throughout their educational years, regardless of any perceived or real barriers such as economic status, culture or level of ability or disability.

We appreciate you taking the time to complete this survey, your opinions and experiences will assist us in improving early childhood services.  Your input is important!

Please refrain from taking this survey more than once.

* 1. What zip code do you live in?

* 2. How do you best like to receive information regarding early childhood opportunities

  Home Public No
Do you have internet access?

* 3. Is anyone in your household currently pregnant?

* 4. Number of Children (indicate the number in each category)

* 5. Early Childhood Programming

  None Needed Still Need Family Friend (do not choose for early childhood programming) Center/School Program In Home Care
What early childhood programming do you use? (not childcare)
For 3-5yr old children, what type of childcare arrangement do you use?
For K – 12-year-old children what type of after-school program do you use?

* 6. Which category does your age fall into?

* 7. What is your highest level of education?

* 8. What is your annual family (household) income?

* 9. How long does it take to get to your place of work, one day, each way

* 10. Location and Transportation

  Yes No NA
If your child is involved in childcare or early childhood programming, do you drop them off/pick them up?
If yes, is the location on your way to your workplace?
Is transportation a barrier to your child’s participation in early childhood programming?

* 11. For each item below, indicate the number that best represents YOUR experience in the past year.

  Never an issue Rarely an issue Sometimes an issue Often an issue Not sure
Do you have access to childcare?
Is it affordable?
Availability of high-quality child care near home or work
Access to services for children with disabilities or special needs
Access to support services for parenting

* 12. What is your greatest concern about raising children?

* 13. What is your greatest concern about preparing children for Kindergarten

* 14. What kinds of programs or services would benefit you and your family?

* 15. Are these programs and services avaiable

* 16. Do you have any other comments or concerns about early childhood in your community?

* 17. Would you be willing to serve on an early childhood committee?