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Home Technology Questionnaire
Thank you for completing this brief questionnaire.
We ask that you complete a separate survey for each school.
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* Indicates required question
Parent/Guardian Name (submitting this survey)
*
Your answer
Home Address
*
Your answer
How many students at this address attend our school?
*
Choose
1
2
3
4 or more
Student Name
*
Your answer
Student Name (2)
Your answer
Student Name (3)
Your answer
Student Name (4)
Your answer
Do you have home Internet access?
*
Yes
No
Do the children in your home have access to a computer or iPad for instructional purposes?
*
Yes
No
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