Remote Learning Hubs - Organizer Info
The information submitted here will be given to KCPS Principals. Please fill out as much as possible.
Sign in to Google to save your progress. Learn more
Organization *
Lead Contact Name *
Please provide the lead contact info for your organization
Lead Contact Phone *
Please provide the lead contact info for your organization
Lead Contact Email *
Please provide the lead contact info for your organization
My organization is - *
Please check all that apply.
Required
Financial Support Estimate
As discussed in our Zoom meeting please describe any financial support you may need to help cover your expenses as a learning hub. This could include broadband installation, monthly provider fees, groceries and cleaning supplies. Please include an estimate for these expenses.
Facility name if different from organization
Additional Contact 1 Name
Additional Contact 1 Email
Additional Contact 1 Phone
Street Address
City
Zip Code
Student capacity
Student capacity at this location only.
Days/Times Available
Please select the earliest drop off and latest pick up time for each day
Monday
Tuesday
Wednesday
Thursday
Friday
7am
8am
9am
10am
11am
12pm
1pm
2pm
3pm
4pm
5pm
6pm
7pm
Internet Access Type and Provider
Please let us know what service you are using and how students would connect to your ISP.
Additional Support
Please let us know if there are any other ways that your organization can support students and families.
Do you want to add an additional facility?
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms