Request edit access
JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Technology Survey
We are collecting information solely for the purpose of planning for future possibilities regarding Alternative Methods of Instruction (AMI). This information will not be shared outside of the district.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Parent/Guardian Name
*
Your answer
Please list the full name(s) of all school aged children in your home, their grade(s) and the building (G, T, HS) they attend. (Example: Tommy Smith, 4th, G)
*
Your answer
What type of Internet do you have at home?
*
Home Internet (Fiber, Satellite, etc)
Cell Phone (Data Plan)
None
Other:
Required
What type of device(s) are available for home learning?
*
Home Device (Desktop Computer, Laptop, etc.)
Mobile Device (Phone, Tablet, etc)
None
Other:
Required
What is the best method to contact you regarding your student(s) and home learning?
*
Phone Call
Email
Text Message
Please list your phone number or email in regard to the previous question (best contact method)
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of East Newton R-VI School District.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report