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Tech Goes Home Pre-Training Survey
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Email address
(Required.)
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4.
Gender
(Required.)
Female
Male
Non-binary / third gender
Prefer not to say
Prefer to self-describe (please specify)
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5.
Date of Birth (MM/DD/YYYY)
(Required.)
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6.
With which group do you most identify?
You may select more than one option.
(Required.)
Asian
Black or African-American, Non-Hispanic
Latinx
Native American or Alaskan Native
Native Hawaiian or Pacific Islander
White, Non-Hispanic
Other
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7.
What is your age?
(Required.)
18-21
22-29
30-39
40-49
50-59
60-69
70-79
80-89
90+
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8.
What is your highest educational level?
(Required.)
Grade 0-8
Grade 9-12 (Non-graduate)
High school graduate or GED
Some college/AA
College graduate
Post graduate
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9.
What is your employment status?
(Required.)
Part-time
Full-time
Unemployed
Retired
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10.
What is your approximate annual household income?
(Required.)
Under $4,999
$5,000-$7,499
$7,500-$9,999
$10,000-$14,999
$15,000-$19,999
$20,000-$29,999
$30,000-$39,999
$40,000 or over
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11.
How many members are in your household (including yourself)?
(Required.)
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12.
Do you have school-aged children in your household?
(Required.)
Yes
No
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13.
Have you participated in any Tech Goes Home class before?
(Required.)
Yes
No
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14.
What is the main reason you decided to participate in Tech Goes Home?
(Required.)
For the computer or tablet
For the training
To meet new people
To get to know the resources and staff at this school/organization
To help prepare my child for kindergarten
To spend time learning with my child
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15.
Which devices do you use at home?
You may select more than one option.
(Required.)
Desktop computer
Laptop
Tablet (iPad, Kindle Fire, LG Tablet, etc)
Mobile phone
None
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16.
How many internet-capable devices do you have at home?
(Required.)
None
1
2
3
4
5+
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17.
Which best describes your level of computer skills?
(Required.)
Expert. I can troubleshoot problems myself and rarely (if ever) need help.
Skilled. I use a computer frequently and do several things very well. I sometimes need assistance.
Average. I regularly use technology at home or work, but I need help for new or unfamiliar tasks.
Learning. I can do basic tasks, but I frequently need help for new ones.
Beginner. I rarely use or have never used a computer.
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18.
How do you access the Internet in your home?
You may select more than one option.
(Required.)
Home Wi-Fi Router or Network (Cable, DSL, Satellite, etc.)
Personal Hotspot
Mobile/Cellphone Data Plan
I do not have access to the Internet
19.
If you have a home wi-fi router, what service do you use?
Leave this question blank if none.
EPB, full-price
EPB EdConnect
Comcast/X-finity
Comcast Internet Essentials (reduced cost)
AT&T
AT&T Access (reduced cost)
AT&T U-verse
PCs for People / Mobile Beacon
Provided through HUD or Public Housing
Spectrum
Bledsoe Telephone Cooperative
I don't know
Other (please specify)
20.
If you have a mobile data plan, which service do you use?
Leave this question blank if none.
AT&T
Cricket
Sprint
T-Mobile
Verizon
I don't know
Other (please specify)
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21.
Have you ever changed or cancelled your Internet subscription (wi-fi or mobile data) because it was too expensive?
(Required.)
Yes
No
I have never had an internet service
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22.
Which type of Tech Goes Home class are you taking?
(Required.)
Community (Adults 18+)
School (parent with school-aged child)
Early Childhood (parent with PreK child)
Small Business / Artist
HCDE Teacher Edition
Early Learning Provider
AAC Teacher / SLP Training
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23.
I hereby give the unqualified right to the Tech Goes Home Chattanooga (TGH CHA) program to take pictures and/or video of our family. I give permission for these images as well as materials that we have created in the TGH CHA program to be used in print and web-based publications. The TGH CHA program will put these images to legitimate use without limitation or reservation.
(Required.)
Yes
No
Current Progress,
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