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Brinkley School District DIGITAL EQUITY SURVEY
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* Indicates required question
Child Name
*
Your answer
Does this child have Internet Access at home?
*
Yes
No
If there is no Internet Access, what is the reason this child does NOT have internet Access?
*
Not Available
Not Affordable
Other
NA -Not Applicable
What type of Internet Access does this child have? (Select one of the following)
*
Residential Broadband
Cellular Network
Hotspot
Community Provided Wi-Fi
Satellite
Dial-up
Other
None
Unknown
Is the Internet Performance acceptable for learning activities? (Select one of the following)
*
Yes - experiences very few or no interruptions in learning activities caused by poor internet performance in the primary place of residence
Sometimes - regularly experiences interruptions in learning activities internet caused by poor internet performance in their primary place of residence
No - unable to complete learning activities due to poor internet performance in their primary place of residence
What type of device does this child use most often to complete learning activities away from school? (Select one of the following)
*
Desktop Computer
Laptop Computer
Tablet
Chromebook
Smartphone
None
Other
What is the source of this primary learning device?
*
District Provided
Personal
Other
What is the child's access to this primary learning device? (Select one of the following)
*
Shared
Not Shared
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