JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Laptop Upcycle Student Delivery Survey
Congratulations! You are the new owner of a laptop.
Laptop Upcycle’s mission it to make sure middle school and high school students have access to a computer and the internet to complete their classroom assignments.
Understanding more about you and how you will benefit from this computer will help our sponsors understand how their donations are being used. It will also help us figure out how to get more laptops for students like you.
Please give us your best answers to the questions below. Your name will never be connected to the information you provide and it is totally confidential. If there are any questions you are not comfortable answering, please skip them.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Please tell about you.
Which school are you in?
*
Montclair High School
Glenfield Middle School
Buzz Aldrin Middle School
Renaissance Middle School
Other:
What gender do you identify as?
Male
Female
Other:
Clear selection
What is your race/ethnicity? (check all that apply)
White/Caucasian
Black/African-American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Hispanic
Other:
Please tell us how you use your computer.
How many days a week do you think you will use your laptop?
Every Day (7)
School Days only (5)
1-2 Days a Week
Clear selection
On days you use your laptop, how many hours do you expect to use it?
Less than 1 hour
Between 1 and 2 hours
3 - 4 hours
Five (5) hours or more
Clear selection
Will anyone else in your family use or borrow your laptop? (check all that apply)
Brother/Sister
Parent
Grandparent
Other:
Will you?
Bring your laptop to school.
Leave it home
Not sure
Clear selection
Do you have internet access at home?
Yes
No
Clear selection
Do you have friends that need a laptop for their school work? If so, please have them contact their guidance counselor or us at
giveget@laptopupcycle.org
.
Yes
No
Clear selection
Before receiving the laptop from Laptop Upcycle today, where did you do your homework that required access to a computer?
Your answer
Now that you have a new laptop, are there technology related topics not offered in your school that you would be interested in learning (for example; programming/coding, electronics, 3D printing, or others)? Please list any below.
Your answer
Finally, please let us know if there is anything you think we could do to improve Laptop Upcycle. What could we do better? Thanks!
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. -
Terms of Service
-
Privacy Policy
Does this form look suspicious?
Report
Forms