Jefferson ISD 2020-21 BACK TO SCHOOL LEARNING MODE SURVEY
The health, safety, and education of our students and staff remains the top priority for Jefferson ISD. We intend to follow all CDC and state health department guidelines in order to assure the safety of our students and staff as we start the 20-21 school year. JISD expects to utilize personal protective equipment (masks, face shields, gloves, etc.), maintain social distancing (to the extent possible), ensure hand sanitizing stations are available and used throughout the buildings/campuses, and expect students and staff to routinely wash their hands. Due to the current issues with COVID-19, we must anticipate and plan for various options regarding the start of school. Therefore, we need some important information associated with each of your households. We are requesting parents to fill out this survey and submit it by Monday, June 29, 2020 so that we can best serve you and the needs of our students. PLEASE FILL OUT ONE SURVEY PER STUDENT IN YOUR HOUSEHOLD. Thank you for your help.
STUDENT FIRST Name
STUDENT LAST Name
Grade for the 2020-21 School Year
STUDENT Physical Address (with city and zipcode)
Parent/Guardian FIRST Name
Parent/Guardian LAST Name
Parent/Guardian Phone Number
Parent/Guardian Email Address
Please select one of two learning environments available for the 20-21 school year for your student(s)? (Remote instruction this fall will NOT be the same as it was delivered this past spring. We will utilize "Google Classroom" for instruction.)
FULLY REMOTE (online) INSTRUCTION
ON CAMPUS (face-to-face) INSTRUCTION
What kind of internet access do you have at home?
Cable or Wired-Connection (Fidelity, ATT, etc)
Unlimited Data Satellite (Hughes Net, Dish, Direct TV, Wild Blue, etc)
Limited Data Satellite (Hughes Net, Dish, Direct TV, Wild Blue, etc)
Unlimited Data Wireless Hotspot (Verizon, Sprint, TMobile, etc)
Limited Data Wireless Hotspot (Verizon, Sprint, TMobile, etc)
What Bus (#) did your child ride this past school year? (Driver's name if you are unsure of the number. Put N/A if no bus.)
Will your child ride the bus to school in the 2020-21 school year?
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This form was created inside of Jefferson Independent School District.