Parent Technology Survey

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The purpose of this survey is to fulfill session law "§ 115C-102.9 calling for the collection and reporting of data
regarding all students access to digital devices and internet access at home. This information will be used to help target areas of need and ensure that all NC students have adequate access to devices and the internet to access learning. Note that the information gathered will be kept private and confidential.

STUDENT NAME *

Does this student have a digital device(s) at home? *

Yes, provided by school.

Yes, provided by home.

Yes, provided by school and home.

Prefer not to answer.

If devices are provided by the home, indicate which device(s) are available for home use. Select all that apply.
*

Apple Desktop

Apple Laptop

Chromebook

Windows Desktop

Windows Laptop

Android/Kindle Tablet

iPad

Windows Tablet

N/A

Prefer not to answer.

Required

If students do not have access to digital devices at home, please indicate the reason(s). Select all that apply.
*

A device is not provided by the school.

A device is too expensive to purchase.

Lack of internet to use device at home.

Family chooses to not purchase a device.

Broken, damaged, or outdated device(s).

Other

N/A

Prefer not to answer.

Required

Do students in your home have consistent internet access at home that is adequate to complete schoolwork?
*

Yes

Sometimes

Prefer not to answer.

Maybe

Which type(s) of internet service does the student(s) have access to at home? Select all that apply.
*

Broadband/DSL

Fiber

Satellite

Dial-Up

Hotspot device

Personal Hotspot from cell phone

Other

N/A

Prefer not to answer.

Required

Please indicate the reason(s) for the lack of consistent, dependable internet access. Select all that apply.
*

Not available where the home is located.

Internet available but not dependable.

Internet available but not adequate.

Internet available but too expensive.

No alternatives provided by school.

No cell signal, hotspots do not work.

Family chooses not to have internet.

Broken or outdated equipment.

N/A

Prefer not to answer.

Required

What other sources do the students have for connecting to the internet outside of the home (when not in
school)? Select all that apply.
*

Internet in school parking lot.

Hotspot provided by the school.

Hotspot provided by the home.

Internet at another home.

Internet at the public library.

Internet within the community.

Internet at a park and ride.

Internet on a school bus.

Internet at other community location.

No regular and reliable internet.

Prefer not to answer.

Required

Home Internet Speed Test-Please START the following Internet Speed Test using the home internet connection and device that your student uses to do their schoolwork. Once the test has finished, please record the results in the below fields or select “Prefer
not to answer”. If you are on a device that is using a cellular service or a device that is not in your home, please select “N/A”. If you selected "No" on Question 1 from the previous page, "N/A" has been selected for you and you do not need to start the speed test.
*

Record Download Speed (Mbps):

Record Upload Speed (Mbps):

N/A

Prefer not to answer

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