Survey of Student Access to Technology at Home
What type of technology do you have reliable access to at home? (Check all that apply)
Cell Phone (smartphone)
Cell Phone (basic phone)
iPad or Tablet
Video game system
I do not have access to anything listed
How do you access the Internet at home?
Wireless Broadband (high speed)
Dial Up (low speed)
Mobile Phone (cell phone)
No Internet Access
If you have Broadband Internet is it reliable?
Are you able to access and /or use your device to do school work?
I can't use a device at home
Very limited access (maybe once or twice a week at most)
Some access (maybe an hour a day)
Medium access (2 to 3 hours a day)
Overall, how comfortable are you using a digital device for school work?
Not comfortable at all
How many members of your household share the device you might use for homework or schoolwork?
If you don't have access to the Internet or a device at home, do you have other ways to use the Internet outside of school?
Yes, library, coffee shops, community center...etc.
Will you be helping to care for other children in the house or doing family chores...etc. while you are home that might make it difficult to participate in a live stream class session at a designated time?
What would you like your teacher to know about technology and you?
What are you parent preferences for digital communication from your teacher? (Check all that apply)
Text Alerts and Text messages
Static Website or Blog
Interactive Website (such as Seesaw, Bloomz, or ClassDojo where they can login)
Anything else that you would like to share about technology in your home?
Anything else that your teacher should know about you being able to use technology to complete your school work?
Do you have transportation to the school for student packet pickups and or grab n go meals?
Is there anything else that Joy should know about your access to transportation to the school?
What questions or comments do you have about getting school work, food, school materials, during the Governor's mandated school closing?
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This form was created inside of Leona Group.