Family Needs Assessment- Technology, Child Care, Meals
Rochester Public Schools is conducting a needs assessment. In order to best serve the needs of our students, we are asking all families to complete this assessment. We are asking for your student name, address, and phone number in order to address individual needs. Your individual responses will be sent to your building principal, and will only be used for this needs assessment.

YOU MUST COMPLETE THIS ASSESSMENT FOR EACH OF YOUR CHILDREN ENROLLED AT RPS. For instance, If you have two children, you would fill out the form for CHILD 1, and submit. You would then complete another form for CHILD 2, and submit.

Para asistencia en español, por favor marque al 328-4241.
Za pomoc na bosanskom jeziku pozovite 328-4243.
"328-4246إذا رغبت في الحصول على هذه المعلومات باللغة العربية يرجي الإتصال بقسم الترجمة على الرقم
Haddii aad jeclaan lahayd in aad hesho macluumaadkaan oo ku qoran Soomaali, fadlan la soo xiriir waaxda EL(bartaha ingariiska) 328 4247.
Sign in to Google to save your progress. Learn more
Email *
Family and Contact Information
What is your child's first name?
What is your child's last name?
What is your primary address?
What is your primary phone number?
What school does your child attend?
What grade is your child in?
Does your household have a technology device for your child to use in Distance Learning?
Clear selection
If you answered yes, what kind of technology device is it?
Do you have broadband internet or access to reliable internet access?
Clear selection
Who is your internet provider?  We use this information to determine if there is enough bandwidth available for all the students in the household.
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Rochester Public Schools ISD 535. Report Abuse
Google Forms