Age 年龄
10-12岁
13-15岁
16-18岁
Other：Please specify其他
Race 种族
A.Chinese 华人
B.Malay 马来人
C.Indian 印度人
D.Other：Please specify其他
What is your relationship to this student您和学生的关系？
A.Mother / Stepmother 母亲/继母
B.Father / Stepfather 父亲/继父
C.Grandparent 祖父母
D.Other：Please specify其他
How many other children do you have currently attending Chinese Independent Schools？您有几个孩子在华文独立中学就读（包括中华独中）？
A.None
B.1 to 3
C.4 to 6
D.7 to 9
Got information about the school and its study provision from（please give the most important source the number 1，the second most important source number 2，etc.you may leave some boxes empty if needed。再决定孩子入学中华独中前，您是从哪里了解到关于中华独中的信息的，把你认为最重要的信息来源标注成1，其次重要的标注成2，一些选项可以不选
1.Job Center 工作中心
2.Internet 因特网
3.Student counsel or Friend or relative 学生咨询会，朋友或是亲戚
4.Media/newspaper 媒体/报纸
5.Other: please specify其他
How would you rate son / daughter's school overall？从总体上您会如何评价您孩子的学校？
A.Excellent出色
B.Good 很好
C.Poor 差
D.No Opinion 不知道
If you could choose any school in the city for your son / daughter，would this school be one of your top three choices？如果当你在这个城市可以随意选择学校时，中华独中会是前三个选择之一吗？
How long has your son / daughter attended this school？您的孩子在这所学校学习多久年？
A.Less than one year 少于一年
B.One to three years 1 至 3年
C.Four or more years 4年以上
What grades does your son / daughter usually get at this school？ 您的孩子在这所学校的成绩怎么样？
A.As and Bs
B.Bs and Cs
C.Cs and Ds
D.Ds and Fs
What is your highest level of education？您的最高学历是什么？
A.Didnt graduate from high school 高中末毕业
B.High school 高中
C.College graduate（4-year degree）本科
D.Graduate or professional degree 研究生
What is the total yearly income of your household？您全家一年的收入是多少？
A.below 10,000$
B.from 10,000 to 24,999$
C.from 25,000 to 39,999$
D.from 40,000 to 54,999$
E.55,000 or more $
The principal and teachers at my son / daughter's school seem to work well together。我孩子所在学校的校长和老师共事良好”
My son / daughter's teacher are up-to- date about things that are happening in subjects they teach。我孩子的老师对于他们所教的科目的知识达到最新的状态”
My son / daughter's teacher are able to make learning exciting and fun。我孩子的老师可以使教学变得生动有趣”
The principal in my son / daughter's School encourages teachers to try new ways of teaching and seems open to new ideas学校校长能接受的思想并鼓励老师尝试用新的方法进行教学。
My son / daughter's teachers are committed to teaching my child教师都致力于教我的孩子”
My son / daughter's school is an orderly place我的儿子/女儿的学校是个有秩序的地方
My son / daughter's school is a safe place to learn我的儿子/女儿的学校是一个安全学习的地方