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LASD Internet/Wireless Survey
Please complete the following survey regarding Internet and wireless connectivity at your home.
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* Indicates required question
Parent Last Name
*
Your answer
Parent First Name
*
Your answer
Does your household have Internet/wireless access?
*
Yes
No
Describe any issues your household has with Internet/wireless access.
*
Your answer
Describe any issues your family may have in completing school assignments at home during the closure.
*
Your answer
Additional Comments or Concerns
*
Your answer
Last Name of First Child in LASD
*
Your answer
First Name of First Child in LASD
*
Your answer
Grade Level of First Child in LASD
*
Choose
PreK
K
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Last Name of Second Child in LASD
Your answer
First Name of Second Child in LASD
Your answer
Grade Level of Second Child in LASD
Choose
PreK
K
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Last Name of Third Child in LASD
Your answer
First Name of Third Child in LASD
Your answer
Grade Level of Third Child in LASD
Choose
PreK
K
1
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Last Name of Fourth Child in LASD
Your answer
First Name of Fourth Child in LASD
Your answer
Grade Level of Fourth Child in LASD
Choose
PreK
K
1
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Last Name of Fifth Child in LASD
Your answer
First Name of Fifth Child in LASD
Your answer
Grade Level of Fifth Child in LASD
Choose
PreK
K
1
2
3
4
5
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11
12
Additional Children in LASD
Your answer
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