Technology Access Survey

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Dear Canby Families,

We are collecting some very important information about your access to technology at home. We need to know whether your students have devices and internet access as we make plans to provide educational opportunities online. Please take a moment to fill out this important survey so we can plan for the next few weeks of the statewide school closure. We need this information from EVERY family in the district. If you do not have technology needs, we need to know that, too.

Please limit to one response per household to avoid duplication. Know that this survey information will be confidential and will only be accessed by school administrators as a way to determine technology needs. We will provide a different form of this survey to families who may not have access to a phone or the internet.

- Please leave blank any questions that aren’t valid for you -

Your first name *

Your last name *

Your email *

The best number to text you *

The best phone number to call you *

Your first Canby student's first and last name *

Your first Canby student’s grade level *

Your second Canby student’s first and last name

Your second Canby student’s grade level

Your third Canby student’s first and last name

Your third Canby student’s grade level

The names and grade levels of any remaining Canby students in your household

What option best describes your internet availability? *

I have dedicated internet service at my home

I have dedicated internet, but it’s not stable enough to support more than one device

I rely on one or more cell phones for online connectivity in my home

I don’t have internet access at my home

I’m working on my own to get internet service and will likely have it by early April

Other:

What option best describes your student’s ability to access a computer with a keyboard, an iPad, or a school-provided iPad? *

The students in my household have access to a device that could be utilized for 2-3 hours per day per student.

The students in my household do not have access to a device that could be utilized for 2-3 hours per day per student.

Other:

Does your student have a dedicated iPad at school that they did not bring home with them when school was closed? If so, please provide that student’s name.

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