Family Readiness Survey
A. Families and Students
[CHECK ALL THAT APPLY]
1. We have one or more students enrolled in ELEMENTARY SCHOOL
2. We have one or more students enrolled in MIDDLE SCHOOL
3. We have one or more students enrolled in HIGH SCHOOL
B. Desktops/Laptops/Tablets at Home for Students Use
How many devices (Desktops/Laptops/Tablet//etc.) do you have at home?[ANSWER ALL THAT APPLY]
4. How many Windows laptops, tablets, or desktop computers (Windows 8.1 or higher)?
5. How many Apple laptops or desktop computers (Mac OS X 10.9 or higher)?
6. How many iPad tablets (iOS 10 or higher)?
7. How many Chromebooks (Chrome OS 75 or higher)?
8. How many other types of internet-connected tablets (e.g., Samsung, Kindle)?
9. How many Internet-connected gaming consoles (e.g., Xbox, Playstation)?
10. How many smartphones (e.g., iPhone, Android, or other)?
11. We have NO devices available for student use.
(Please check if the statement applies)
12. How many hours per day on average can each student spend on the device(s) available at home?
C. Internet Access at Home
What type of internet connections do you have in your home? [CHECK ALL THAT APPLY]
13. "Wired" Broadband (through DSL, fiber, or a cable provider)
14. "Wireless" Broadband (using satellite, 5G, Wi-Fi, or hotspot)
15. Dial-up (through the phone company)
16. Smart phone/cell phone (with a cellular data plan)
17. We have NO internet access at home.
D. Quality of Internet Access
What is the quality of internet access that you have in you home?
18. Excellent access (reliable with unlimited data)
19. Average access (mostly reliable with sufficient amount of data)
20. Poor access (unreliable and/or very limited data)
21. Occasional access (e.g., through family, library, or public Wi-Fi)
22. We have NO internet access at home.
E. Home Internet Uses
How do you use the internet in your home? [CHECK ALL THAT APPLY]
23. To participate in video chats or video call while at home.
24. To download video/audio content while at home.
25. To stream video/audio content while at home.
26. To play online multiplayer video games while at home.
27. To print document and other materials from websites.
F. Special Needs
What types of special supports do you need to access digital learning at home? [CHECK ALL THAT APPLY]
28. Translation services
29. Closed captioning services
30. Other special accommodations
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This form was created inside of Coahoma County School District.