PK-6 GEERS Grant Student Internet Survey
This survey is to provide data to support a grant that promotes technology equity among students at Hershey.  One form per household.  
* Indicates required question
Your First and Last Name *
Your answer
Student #1 *
Please list all PK through 6th Grade students in the home who attend Hershey.  
Your answer
Student #2
Your answer
Student #3
Your answer
Student #4
Your answer
Student #5
Your answer
Student #6
Your answer
I have Internet at home.   *
Required
My main Internet access at home comes from _________.   *
Required
The company that provides my Internet is _____________.
The MAJORITY of the time, how consistent is your Internet connection?   *
Required
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