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Forms

Did you successfully complete the program?
Did you voluntarily leave the PI program?
Were you teminated from the program?
Where do you and/or your child(ren) currently live?
Do you currently receive public assistance?
Check all that apply.
Do you have your High School Diploma?
Do you have your GED?
Did you receive your High School Diploma or GED:
Are you enrolled in college?
Are you currently enrolled in a certificate or other educational program?
Are you currently employed?
Please mark any of the following services for which you or your child need assistance:
Would you recommend the PI program to a friend?
optional
optional

Thank you for taking time to complete this survey.

2018 Highlights of Individuals & Families Served

© 2019 Children's Aid Society

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