Technology Access and Proficiency Evaluation Form
Please complete this form to help us understand your access to technology and your proficiency with digital tools.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Role or Position (e.g., Student, Teacher, Staff)
*
Please Select
Student
Teacher
Staff
Other
Which of the following devices do you have regular access to? (Select all that apply)
*
Desktop Computer
Laptop
Tablet
Smartphone
None
Other
How reliable is your internet connection at your primary location?
*
Very reliable (rarely disconnects)
Somewhat reliable (occasional issues)
Unreliable (frequent issues)
No internet access
How often do you use the following technologies?
*
Rows
Daily
Weekly
Monthly
Never
Email
1
2
3
4
Word Processing (e.g., MS Word, Google Docs)
5
6
7
8
Spreadsheets (e.g., Excel, Google Sheets)
9
10
11
12
Video Conferencing (e.g., Zoom, Teams)
13
14
15
16
Learning Management Systems (e.g., Canvas, Moodle)
17
18
19
20
Rate your proficiency with the following technologies.
*
Rows
Beginner
Intermediate
Advanced
Expert
Operating Systems (Windows/Mac/Linux)
21
22
23
24
Cloud Storage (e.g., Google Drive, Dropbox)
25
26
27
28
Presentation Tools (e.g., PowerPoint, Slides)
29
30
31
32
Collaboration Tools (e.g., Slack, Teams)
33
34
35
36
Basic Troubleshooting (e.g., restarting devices, installing apps)
37
38
39
40
Which of the following software or platforms do you feel you need more training or support with? (Select all that apply)
Email
Word Processing
Spreadsheets
Video Conferencing
Learning Management Systems
Cloud Storage
Presentation Tools
Collaboration Tools
Other
What is your preferred method for receiving technology training or support?
Online tutorials or videos
In-person workshops
One-on-one coaching
Written guides/manuals
Other
Please provide any additional comments or suggestions regarding technology access or support needs.
Submit Evaluation
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