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Just in Time Parenting Program's: Guide to Evaluation

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19. Are you:<br />

(check all that apply)<br />

___ Asian<br />

___ Black/African American<br />

___ Hispanic/Lat<strong>in</strong>o/Lat<strong>in</strong>a<br />

___ Native American/American Indian<br />

___ White<br />

___ Other (please specify) ______________________<br />

20. At this time, are you employed for pay?<br />

(check one answer)<br />

___ No<br />

___ Employed for pay 1 <strong>to</strong> 20 hours a week (at home or out of home)<br />

___ Employed for pay 21 or more hours a week (at home or out of home)<br />

21. What is the highest level of education you have completed?<br />

(check one answer)<br />

___ Less than high school<br />

___ High school diploma or GED<br />

___ Vocational/technical tra<strong>in</strong><strong>in</strong>g<br />

___ Some college<br />

___ College degree(s)<br />

22. In which state do you live? _______________________________<br />

23. Is there anyth<strong>in</strong>g else you would like <strong>to</strong> tell us about <strong>Just</strong> <strong>in</strong> <strong>Time</strong> Parent<strong>in</strong>g? Th<strong>in</strong>gs that you liked or some th<strong>in</strong>gs<br />

that you didn't like? Any suggestions that would help us improve? Please write <strong>in</strong> your comments below.<br />

____________________________________________________________________________________<br />

____________________________________________________________________________________<br />

_______________________________________<br />

1/14/2008 Page 17 of 51

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