Technology Empowerment Survey
Help us understand your access to and experiences with technology. Your responses will guide future efforts to improve digital empowerment.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
What is your age group?
*
Under 18
18-24
25-34
35-44
45-54
55-64
65 or older
What is your current occupation?
*
Please Select
Student
Employed (Full Time)
Employed (Part Time)
Self-Employed
Unemployed
Retired
Other
Which of the following devices do you regularly use? (Select all that apply)
*
Desktop Computer
Laptop
Tablet
Smartphone
Smart TV
None
Other
How would you rate your overall digital skills?
*
1
2
3
4
5
Please indicate your confidence with the following digital tasks:
*
Rows
Very Confident
Somewhat Confident
Not Confident
Never Tried
Browsing the internet
1
2
3
4
Sending emails
5
6
7
8
Using office software (e.g., Word, Excel)
9
10
11
12
Participating in video calls
13
14
15
16
Protecting personal information online
17
18
19
20
How often do you access the internet?
*
Multiple times a day
Once a day
A few times a week
Rarely
Never
What are your main reasons for using technology? (Select all that apply)
*
Education
Work
Socializing/Communication
Entertainment
Shopping
Other
What challenges or barriers do you face in accessing or using technology?
What types of support or resources would help you feel more empowered with technology?
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