Student School Supplies Survey
Help us understand your access to and needs for school supplies so we can better support you.
Student Full Name
*
First Name
Last Name
Grade Level
*
Please Select
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Other
School Name
*
Which of the following school supplies do you currently have? (Select all that apply)
*
Backpack
Notebooks
Pens/Pencils
Erasers
Ruler
Colored Pencils/Markers
Calculator
Folders/Binder
Glue/Scissors
Other
Which school supplies do you currently need or lack? (Select all that apply)
*
Backpack
Notebooks
Pens/Pencils
Erasers
Ruler
Colored Pencils/Markers
Calculator
Folders/Binder
Glue/Scissors
Other
How satisfied are you with the school supplies you currently have?
*
1
2
3
4
5
How often do you have trouble completing assignments due to a lack of supplies?
*
Never
1
2
3
4
Always
5
1 is Never, 5 is Always
Please indicate your agreement with the following statements about school supplies:
*
Rows
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
My school provides enough supplies for me to succeed.
1
2
3
4
5
My teachers help me get supplies if I need them.
6
7
8
9
10
Having the right supplies helps me learn better.
11
12
13
14
15
Which one school supply do you consider most essential for your learning?
*
Backpack
Notebooks
Pens/Pencils
Calculator
Folders/Binder
Other
Would you like to be contacted for follow-up or to receive supplies?
*
Yes
No
If yes, please provide your email address:
example@example.com
Please share any additional comments or suggestions about school supplies:
Submit Survey
Should be Empty: