Student Access To Technology Survey
Student Name
First Name
Last Name
Student ID #
Grade
School Name
Parent Name
First Name
Last Name
Email
example@example.com
Please answer the following questions
Rows
Yes
No
Do you have access to a printer at home?
1
2
Do you have a personal Smartphone?
3
4
Do you require a District issued chrome book to complete remote learning?
5
6
Does your family have access to reliable internet?
7
8
Which technologies do you use at home?
Desktop PC
Laptop
iPad
Android Tablet
Kindle
Chromebook
Other
Your Internet connection?
Broadband - via cable or vendor hotspot
DSL - through phone company
Dial-Up - must connect via phone dial
No internet access
Other
Can you access and/or use your computer at home to do schoolwork?
Can't use computer at home
Limited access - 1 - 2 hours per day
Medium access - 3 - 4 hours per day
Unlimited access
Other
Additional Notes
Submit
Should be Empty: