Internet Access - Grades 3-12
This form is being used to collect information regarding your Internet Access. You may use this form to report that you do NOT have internet access or if you have had a change in situation from no internet to currently having internet.

Alternate materials will be provided for your child if needed.

(Generally if you can watch YouTube videos, your internet is sufficient for distance learning materials.)
Do you have adequate internet for distance learning? *
Parent Name (Last, First) *
Your answer
Parent Email *
Your answer
Student Name #1
Last name, First name
Your answer
Student Grade #1
Check
Student Name #2
Last name, First name
Your answer
Student Grade #2
Check
Student Name #3
Last name, First name
Your answer
Student Grade #3
Check
Student Name #4
Last name, First name
Your answer
Student Grade #4
Check
Student Name #5
Last name, First name
Your answer
Student Grade #5
Check
Submit
Never submit passwords through Google Forms.
This form was created inside of Pine City Public Schools, ISD #578. Report Abuse