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PARENT MENTOR
 QUESTIONNAIRE 
 
Name: 
Address: 
City:      Zip Code: 
Home Phone:      Cell Phone: 
Email Address: 
 
How many children do you have? 

Please list their names and ages, as well as any medical or educational disabilities:

Please list any training that you have attended related to disabilities or special education law:

How would you describe your relationship with your child's school district?

Please describe any/all past volunteering experiences:

What resources do you use most often?

How many IEP's have you attended to provide support to other parents?

What are your strengths in IEP negotioations?

What area's do you feel you need more support or training in?

What area's are you most comfortable/knowledgeable in?

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