Remote Learning Questionnaire

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Remote Learning Questionnaire

Thank you for taking the time to fill out this Google Form. I would like to have an understanding of the home learning environment for remote learning in order to help your child be as successful as possible.

* Indicates required question

Email *

Your email

Parent(s)/Guardian(s) First and Last Name *

Your answer

Student First and Last Name *

Your answer

Relationship to Student *

Mother

Father

Grandparent

Step-Parent

Other:

Best phone number to reach you in case of emergency change of plans: *

Your answer

Do you have reliable internet available at home? *

Yes

No

Does your student need a Chromebook from the school? *

Yes

No

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