Request edit access
NEAAAT COVID-19 Survey
Please complete and submit this survey so that we can continue our preparedness efforts. All responses will remain confidential. We appreciate your time and effort to help us prepare for all potentialities.
Parent/Guardian Last Name *
Your answer
Parent/Guardian First Name *
Your answer
How many students in your immediate family are enrolled at NEAAAT? *
Your answer
Do you have Wi-fi/internet access at home? *
When NEAAAT has an RLP day, is your student(s) able to connect to WiFi? *
From which county would your student connect in the event of an extended RLP period? *
In the event of an extended RLP (1 full week or more), would you need food assistance for your children? *
If you would be in need of food assistance, how many children would be in need of assistance in your immediate family (ages birth-18)?
Your answer
If you would be in need of food assistance, at which of the following times would you be able to pick up food from one of NEAAAT's regional stops? Please check all that apply.
If you would be in need of food assistance, may we contact you? If so please leave your best contact information below.
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Northeast Academy. Report Abuse