Name:

E-mail:

1. Do your children go to: (home school) (private school) (public school)

2. Are you on a waiting list at another school? (yes) (no)

3. a.  Are you interested in sending your children to a private school? (yes) (no)

  b.  If so, for which grades (Aug. 2003)? (K3) (K4) (K5) (1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12)

4. Would President Bush’s $2500 per private schooled child tax credit plan interest you in a private education? (yes) (no)

5. If you home school:

  a.  Would you be interested in foreign language, sports, & fine arts for your child? (yes) (no)

  b.  Would you be interested in having home school support for yourself? (yes) (no)

6.  What are your reasons for having a private school?

7.  What are your major educational goals of a private school?

8.  Are you interested in donating to Richmond Academy: (Time) (Money) (Other Resources)

9.  Are you interested in being employed by Richmond Academy? (Yes) (No)

10.  If so, what skills do you offer? 

11.  Other Comments:

12. Please give address of one other family that we may contact about Richmond Academy.