Student Digital Equity Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Required By MDE Reporting

Student First Name *

Student Last Name *

Student Grade *

Early Childhood

Student Primary Home Address *

Student Primary Home City *

Digital Device Access Section- Does the student use an electronic device like a computer, tablet,(i-Pad) or smart phone to complete homework? If no, skip to Internet Access section. *

Yes

If yes, what type of electronic device does the student usually use to complete homework? select only one

Desktop or laptop

Tablet (i-Pad)

Chromebook

Smartphone

other

Clear selection

Is the device selected in the previous question provided by the school?

Yes

Clear selection

Is the device shared with anyone else in the home?

Yes

Clear selection

Internet Access section - Can the student access the internet on their electronic device at home?

No - internet is not available at home (skip to the end of the survey)

No - internet is not affordable at home (skip to the end of the survey)

No - other (skip to the end of the survey)

Yes

Clear selection

What kind of internet service do you have at home?

Residential Broadband (e.g. Cable, Fiber, DSL)

Cellular Network

School Provided Hotspot

Satellite

Dial up

other

I am not sure

Clear selection

Can the student stream a video on their electronic device ?

Yes - with no pauses or buffering

Yes - with some pauses or buffering

No - Streaming does not work

Clear selection

Using this link, what mbs speed is your download internet connection shorturl.at/hnwFV

less than 1 mbs

1-5 mbs

5-25 mbs

greater than 25 mbs

Clear selection

Using this link, what mbs speed is your upload internet connection shorturl.at/hnwFV

less than 1 mbs

1-5 mbs

5-25 mbs

greater than 25 mbs

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Little Fork- Big Falls School District. Report Abuse

Forms