Digital Equity Survey
To verify the need of students in order to ensure all students have equal access to technology as well as the tools necessary. Please fill out 1 SURVEY PER STUDENT (Grades Pre-K through 12) that attend Cozad Community Schools.
Below enter Student Name that lives in your residence (remember you must complete a separate form for EACH of your children that attend Cozad Community Schools).
Student Last Name
Student First Name
Student Current Grade
Primary residence address
What device does the student most often use to complete school work at home?
None-No Device Available
Is the primary learning device a personal device or school-provided? Is the primary learning device shared with anyone else in the household?
Personal - Dedicated (one person per machine)
Personal - Shared (sharing among others in household)
School Provided - Dedicated
School Provided - Shared
Can the student access the internet on their primary learning device at home?
No - Not Available
No - Not Affordable
No - Other
What is the primary type of internet service used at the residence?
Residential Broadband (e.g., DSL, Cable, Fiber)
Can the student stream a video on their primary learning device without interruption?
Yes - No issues
Yes - But not consistent
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This form was created inside of Cozad Community Schools.