Survey of Parents/Students
Thank you for taking the time to complete this survey so we can ensure all students have the support they need during a potential school closure.
What is your first and last name?
What is your current phone number?
What is your current email address?
Would individuals in your home (who are under the age of 18) be interested in participating in free breakfast and lunches?
breakfast & lunch
How many people under the age of 18 reside in your home?
Do you have access to any of these electronic devices at home (mark all that apply)?
tablet or iPad
I do not have a device at home
Do you have access to reliable wi-fi at your home that is sufficient to participate in online learning?
Never submit passwords through Google Forms.
This form was created inside of Leona Group.