Distance Learning Survey
Parent Name
First Name
Last Name
Student Name
First Name
Last Name
Email
example@example.com
Name of School
Grade
Please Select
Pre K
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Have you joined our Class Group yet?
Yes
No
What type of internet access do you have at home?
Dial-Up
DSL.
Cable
Wireless
Cell phone
Do not have access to the internet
No idea
Rows
Satisfied
Dissatisfied
How satisfied or dissatisfied were you with the content of the course?
1
2
How satisfied or dissatisfied were you with the ability to navigate through the course?
3
4
How satisfied or dissatisfied were you with the format of the course?
5
6
Friendliness
7
8
Rows
Yes
No
All the images and text in the course are clearly visible
9
10
Sounds in the course are clearly audible
11
12
Information in the course is easily understandable
13
14
Friendliness
15
16
How do you rate your experience in this course?
Worst
1
2
3
4
Best
5
1 is Worst, 5 is Best
Comments
What changes would you recommend to improve this course?
Submit
Should be Empty: