Homework Help Entrance Questionnaire

Thank you for registering your child / yourself in Homework Help. Every year, this amazing program is made possible through generous funding from sources outside the PGPL. To help us keep this wonderful program running year after year, please complete the following entrance questionnaire. When the program ends, you will also be contacted and asked to complete a more detailed exit questionnaire. Your responses may be shared in provincial reporting, future grant applications, or marketing materials.

Your personal information will NOT be shared, and will be used only to match the entrance and exit questionnaires for individual students. Once an entrance and exit questionnaire have been submitted for an individual (or 30 days after the end of the Homework Help program, if only one questionnaire is submitted), the responses will be separated from the personal information and all personal information will be erased.

Basic Information
*Your phone number will be used to match your entrance and exit questionnaires. Once both questionnaires have been submitted, the phone number will be erased. Please use the same phone number for both questionnaires. It does not need to be the same phone number you used to register for the program. If you complete only one questionnaire your phone number will be erased within 30 days of the end of the program.*
Please complete as many of the following as you are able/willing.
English
French
Science
Math

Personal information on this form is collected under the authority of the Library Act, R.S.B.C. 1996, c.264 and section 26c of the Freedom of Information and Protection of Privacy Act, R.S.B.C. 1996, c.165. If you have any questions about the collection, use, and disclosure of this information, please contact the Prince George Public Library’s FOI/Privacy Officer at 888 Canada Games Way, Prince George, BC, V2L 5T6 or by phone at 250‐563‐9251. This form will be retained in either paper or electronic form as a record of your agreement.