At Home Technology Access Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Email *

Please type your student's first and last name in the box below. *

Which technological devices do you have in your home? (select all) *

Desktop/PC

Laptop

iPad

Android Tablet

Kindle

Chromebook

I do not have any devices in my home

Other:

Required

Do you have internet access? *

Yes

Is your student able to access and/or use a device(s) at home to do schoolwork? *

Yes

There are no devices (desktop, laptop, tablet, etc.) in my home.

Do you have access to a printer at home? *

Yes

Does your student have their own smartphone? *

Yes

If your student has a smartphone, does it have a data plan that allows them to connect to the internet? *

Yes

My student does not have a smartphone.

If your student has an internet capable smartphone, is your student allowed to use their phone to complete schoolwork. *

Yes

My student does not have an internet capable smartphone.

Does your student have any technology needs that are preventing them from completing their daily work? If yes, please click other and explain. *

Other:

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy