K-4 Distance Learning Survey
Email address *
Last Name of Student *
First Name of Student *
Grade Level *
Teacher Name *
Parent/Guardian Name and/or Person Filling Out Survey Name *
What is the best number for us to use in case we need to make contact with you? *
If you have another student at MCS, please enter the name and grade level here.
What device(s) does you child have access to at home? *
Required
What way(s) does your child have to access the internet?
Clear selection
How much access time does your student have with the following types of devices? *
Full Access (Both Day and Evening)
Limited Access (Shared Family Device)
No Access
Computer
Tablet
SmartPhone
None
For each of the following devices, please indicate what time of day your students will have the BEST access? *
8AM-12PM
12PM-4PM
4PM-8PM
No Access
Computer
Tablet
SmartPhone
None
Please provide any other information about your childs access to devices and wifi at home. *
If we are unable to go back to school for several weeks will you need food service? *
Is there anything else you might need to get through the Coronavirus (COVID-19) pandemic?
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