This is the student survey I assign as homework for my Junior High students on the first or second day of school. The students must take it home and have their parents complete a portion on the back. That way, I have the parent's signature and preferred method of contact by the end of the first week. I also include an extra credit opportunity, by having the parent email me, so then I have their email stored!
This is a Word document which can be edited, and the RED sections are the parts that you should customize.