School Closure Family Survey

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Our District is taking a proactive approach to planning for all scenarios as related to the ongoing situation with Covid-19. We want to ensure we're equipped to temporarily switch to distance learning if we are instructed to close for a sustained period of time after Spring Break. As a part of this, we want to ensure that our family have the devices to support learning.

This survey is confidential.

Teacher Name (Last Name)

Caregiver Name (Last Name /First Name)

Student Name (Last Name /First Name)

Does your child have access to a reliable device other than a phone at home?

Please indicate "sometimes" if your child shares a reliable device with another family member.

Yes

Sometimes - it is shared with the family

No - we do not have a reliable device at home

Clear selection

How would you describe your internet access at home?

Excellent -- reliable and unlimited

Average -- mostly reliable and a sufficient amount of data

Poor -- unreliable and/or very limited data

Occasional access (e.g. through family, library, or public wifi)

No internet access

Clear selection

Do you have access to a printer?

Yes -- reliable printer, ink, and paper

Yes -- but can only be used minimally

No -- no printer access

Clear selection

How does the main caregiver feel about assisting with school work (including technology) during school hours?

Severely lacking confidence and/or time

Very confident and plenty of time

Clear selection

Do you have any other questions or concerns that you'd like me to know if our school was required to transition to extended online learning in the future?

Submit

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