We want to make sure we send you information that helps you better understand the law that supports children with disabilities (IDEA — Individuals with Disabilities Education Act). To aid us in doing this, please fill out the NCPIE/FAPE questionnaire below.

1. Choose one:
   parent/guardian of child with disability
   professional
   advocate
   None of the above, but I would like information about IDEA'97 (skip to #8)

2. Child's age

3. Are special education services working for your child/children?
   Yes
   No

4. If not, what is the main problem?
   

5. Do you know how to get special education services for your child/children in your school?
   Yes
   No

6. Do you know about your rights under IDEA?
   Yes
   No

7. What would help you get better services for your child?
   

8. What information do you need? Check all that apply:
   Evaluation Process
   IEP planning
   Related Services (such as speech and language, physical therapy etc.)
   Placement
   Participation in general curriculum
   Participation in statewide assessments
   Discipline
   Parent rights and responsibilities
   Student rights and responsibilities
   Resolving disagreements
   Finding someone to help me
   Transition planning
   Graduation
   Private schools
   Other

9. How do you get information?
   Through an individual (in-person or phone call)
   Written materials
   Workshops
   Internet

10. Where do you live? (Please check one)
    Rural area
    Suburb
    Urban Area (city)

11. Which of the following most closely describes your race/ethnicity? (Check one)
    African-American
    Caucasian
    American Indian
    Hispanic/Latino
    Asian/Pacific Islander
    Other (please explain)
    

12. Have you ever contacted a national organization (such as FAPE or NICHCY) or a state organization (such as your Parent Training and Information Center — PTI) for help and information on disability issues? If yes:

    Name of national organization
    Name of state organization

13. Would you like someone to contact you? If yes,
    Your name
    
    Your phone number and/or E-mail address
    

Many thanks for taking the time to complete this!