Beaumont Technology Survey
Dear Parents and Guardians,

In response to recent school closures, we are gathering information about the ability of our students to continue learning at home using online materials and/or a virtual classroom.
Please complete the following survey to help us understand the availability of the internet and devices in your home.
This will allow us to determine what supports we can provide our students to support continued learning at home.
Harmony may be able to lend one hromebook per family, based on a first-come-first-served basis.

Thank you.
Email address *
Student 1 Name *
Student 2 Name
Student 3 Name
Other Student Names
Student Grade Level(s) (please check ALL that apply) *
Parent/Guardian FIRST name? *
Parent/Guardian LAST name? *
Do you have internet access at Home? *
Do you have a technology device available for at-home learning your student can use (computer, Chromebook, iPad, etc)? *
If you have answered NO to the last two questions, Harmony may issue a Chromebook device (based on a 1st-come-1st-serve basis) and please visit the guide at school website to get free internet for 60 days.
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Harmony Public Schools.