1. Default Section

* 1. Please enter today's date and time.

Today's Date & Survey Start Time:
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* 2. Please tell us your contact information.

* 3. Are you currently employed?

Please check all that apply to you.

* 4. If currently employed, do you use a computer while working?

Please check only one box to best describe your answer.

* 5. Do you use the internet while working? If yes, please describe some of how your job requires you to use the internet.

For example, one might answer this question as follows:
"At work I have to check my email for requests from customers, make sure office memos are distributed through email, and schedule all appointments for my supervisors."

* 6. Do you currently have a computer in your home?

Please check all that apply to you.

* 7. Please briefly describe some of how you use the computer at home.

For example, one might answer this question as follows: "At home I use the computer to check my personal email, to look for recipes, and to visit MySpace."
OR "Since I do not have internet at home, I use the computer to play games, to write letters, or to work on my resume."

* 8. Are you interested in learning more about using the internet? Please choose only one answer.

* 9. Would you be interested in attending a weekly workshop on learning basic internet skills. Some of what you would learn in this class would be: how to set up an email account, how to do basic internet research, and how to look for job opportunities.

Please choose the best answer that describes your interest in attending a basic skills workshop.

* 10. Please describe what types of workshops would interest you in learning more about the internet?

Please understand that as our organization further develops, we will have resources, such as money and staff, to implement additional workshops. This question helps us to plan for further training that we may want to make available, should there be significant interest.

*Also, please tell us when would be the best time of day or evening for you to participate in workshop(s).

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