Technology Needs Survey

Please complete this survey for each of your children. The information is needed to determine student technology needs. The information submitted is confidential. Questions about the survey may be directed to the Office of Information Technology.

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* 1. Student's First Name

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* 2. Student's Last Name

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* 3. Student's School

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* 4. Student's Grade Level for the 2020-21 School Year

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* 5. Parent Contact Info

Parent's Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

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* 6. Do you have internet access at home?

Yes

No

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* 7. Does this student have a Computer (Laptop/Desktop/Tablet) at Home?

Yes

No

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* 8. What is your household income? This information will be used to determine eligibility for free internet service.

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* 9. How many people are in your household?

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* 10. I would like for my child to participate in the following delivery model for 2020-2021 school year.