Family Resource Survey
Please complete one time per household.
Email address *
Name of adult completing survey *
Your answer
BEST phone number for the household. (Choose only one primary number.) *
Your answer
Names of ICS students living in your household *
Your answer
Right now, do you predict that your family will have the time and adult/family support to assist students with some at-home learning activities while school remains closed? *
Does your family currently have access to everything you need at home for online learning activities? This includes reliable internet access and enough tech devices for children in the household to share. If your answer is YES, you can STOP after you answer this question and SUBMIT the survey. *
If you do not have everything you need for online learning, please check the boxes below to indicate what you do NOT have access to currently. Check all that apply.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Independence Charter School. Report Abuse