1) As the school develops, are you interested in receiving more information, in the form of an email newsletter?
(We do not share any information!) If so, please provide your name and email address:
Name
Email
 
2) Do you have children?

 
3) What ages are your children now?
 
4) If your children are of school age, what type of school do they attend?






 
5) In what school district(s) do your children currently attend?














 
6) Below is a list of educational characteristics that we are considering implementing in our school.
Please indicate your level of interest for each characteristic.
Not
Interested 		Somewhat
Interested 		Very
Interested 		Don't Know
Not Sure
1. Positive Discipline/Nonviolent Communication
2. Low Teacher to Student Ratio
3. Environmentally sustainable facilities and policies
4. A high level of student power in decision making
5. Multi-age and flexible class grouping
6. An emphasis on play
7. An emphasis on being outside in nature
8. Areas of Educational Focus:
a. Personal growth and development at all levels of being
b. Environmental/Earth studies
c. Health, nutrition, and wellness
d. Arts including visual arts and music
e. Handwork and crafts
f. Life skills and vocational studies
g. Hands-on projects and experimentation
h. Interdisciplinary studies
i. Student self-design of projects following own interests
 
7) If you have school-aged children, what is your level of interest in this school?




 
8) If you have school-aged children, how far would you consider traveling for such a school?






 
9) Are you interested in helping to found this school?


 
10) Are you involved in any organizations or businesses that would want to know about the school?
If so, please list their names and contact information.

 
11) We are very interested in your opinions. Please use this space to add your comments.