Survey of student access to technology at home
Email *
Your Name *
What 
type
 of
 technology
 do 
you have reliable access to 
at
 home?
(Check 
all
 that
 apply)
How
 do
 you 
access 
the 
Internet 
at
 home?
Clear selection
If you have Broadband Internet is it reliable?
Clear selection
Are
 you
 able 
to
 access
 and /or 
use 
your
 device 
to
 do
 school work?
Clear selection
Overall, how comfortable are you using a digital device for school work?
Not comfortable at all
Very comfortable
Clear selection
Have you ever had trouble using your digital devices at home to complete school related work?
Clear selection
How many members of your household share the device you might use for homework or schoolwork?
Clear selection
If you don't have access to the internet or a device at home, do you have other ways to use the Internet outside of school?
Clear selection
Will you be helping to care for other children in the house or doing family chores...etc. while you are home that might make it difficult to participate in a live stream class session at a designated time?
Clear selection
What would you like your teacher to know about technology and you?
What are your or your parents preferences for digital communication from your teacher? (Check all that apply)
Any thing else that you would like to share about technology in your home?
Anything else that your teacher should know about you being able to use technology to complete your school work? *
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