TEMPLATE: Online Transition Class Survey
This form was created by Sandra Martinez from Centennial College LBS to see how ready the students in her class are to learn online. She has kindly shared with us for people who would like to adapt it for their own use.

I copied the questionnaire so I can easily share it with people upon request: tracey@alphaplus.ca

Here is how Sandra introduced the questionnaire:

Hello Class,

As I prepare to transition our lessons online, I wanted to send out a class survey for all students to participate in to help me best support you during this transition. If you see any challenges in being able to access the internet/computers or any other problems (ex: childcare, taking care of family members, etc.), please indicate them in the space below.

To best support students who do not have access to the internet/computers, please reply to this survey by Thursday, March 19th, 2020.

The results of this survey are only accessible by me and will not be shared with others. Additionally, I will only call you if you request it via email at a mutually convenient time.

If you have any other questions/concerns, please share them below OR email me at XXX.

Thank you,

Sandra Martinez (Prep 1)

NOTE: Thank you, Paula Elias (Prep 2), for this wonderful idea!


Please write your name: *
Your answer
Do you have a computer or laptop at home? *
If you do not have a computer or laptop, where would you go to access one?
Your answer
Do you have internet connection at home? *
Are you able to use your phone to check eCentennial, download apps, or watch videos? *
On a scale of 1 - 5, do you feel comfortable navigating eCentennial? (1 = not comfortable at all - 5 = very comfortable). *
Not comfortable at all.
Very comfortable.
I can... (check all applicable) *
Required
Are there any challenges you see in transitioning to online classes for the period of March 23rd - April 3rd that you would like to share? (Ex: no WiFi, access to computers, childcare, etc.) *
Your answer
Should you have difficulties in joining an online meeting or need support by telephone, do you provide permission for me to contact you on your cellphone/landline? I will only call you when you request me to via email. If yes, please provide a contact number below. *
If you clicked YES above, please provide a phone number I can reach you at below.
Your answer
Do you have any questions or concerns you would like to share?
Your answer
Submit
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